Objective To explore the effect of Internet of Things (IoT) based smart hospital applications utilized in the department of respiratory and critical care medicine. Methods A total of 161 patients hospitalized in the first division of the department of respiratory and critical care medicine were treated as a control group and were subjected to conventional care, while 160 patients in the second division served as a smart nursing group and received nursing care that was provided by utilizing smart hospital IoT systems in infusion management, health education, check of medical orders, query for diagnosis and treatment information, structured documentation of nursing records, intelligent management of nursing quality, etc. There were 14 nurses in both divisions. The effect was evaluated after 2 months of intervention. Results The incidence of infusion-related adverse events, the number of call bell requests, the effect of health education, patient satisfaction and the score of patients′ self-perceived burden were significantly better, whereas nurses′ workload, work stress and workplace fatigue were significantly lower in the smart nursing group compared with the control group （P＜0.05,P＜0.01）. Conclusion Application of smart hospital IoT systems can improve nursing efficiency, treatment safety and patient satisfaction, but reduce nurses′ work stress and workplace fatigue, which is beneficial to optimize patients′ experience of hospitalization and nursing staff′s work experience.