Objective To investigate the application value of modified early warning score combined with predictive nursing in patients with severe heart failure. Methods A total of 80 patients with severe heart failure who were admitted to our hospital from February 2020 to February 2022 were enrolled and divided into control group and observation group by drawing lots, with 40 patients in each group. The patients in the control group were given routine nursing, and those in the observation group were given modified early warning score combined with predictive nursing in addition to the intervention in the control group. The two groups were compared in terms of cardiac function, psychological state, and the incidence rates of adverse events. Results There were no significant differences in clinical data between the two groups (P>0.05). Before nursing, there were significant differences in cardiac function parameters between the two groups (P<0.05), and after nursing, the observation group had significantly better cardiac function parameters than the control group (P<0.05). Before nursing, there was no significant difference in psychological state score between the two groups (P<0.05), and after nursing, the observation group had a significantly better score than the control group (P<0.05). The observation group had a significantly lower incidence rate of adverse events than the control group (P<0.05). Conclusion For patients with severe heart failure, modified early warning score combined with predictive nursing can improve cardiac function, relieve poor psychological state, and reduce the incidence rate of adverse events.