Objective To explore the effect of high quality nursing on preventing phlebitis caused by venous indwelling needle and improving skin swelling in elderly patients. Methods Sixty elderly patients who underwent peripheral venous indwelling needle infusion in our hospital from January to December 2021 were selected as the research objects. They were divided into control group and study group by random number table method, with 30 cases in each group. The control group was given routine nursing, and the study group was given high-quality nursing on the basis of the control group. The psychological status, phlebitis, skin swelling severity and nursing satisfaction were compared between the two groups. Results The HAMD score and HAMA score of the study group were lower than those of the control group (P <0.05). The incidence of phlebitis in the study group was 36.67%, which was lower than 6.67% in the control group (P <0.05). The severity score of redness and swelling in the study group was lower than that in the control group (P <0.05). The nursing satisfaction of the study group was higher than that of the control group (P <0.05). Conclusion The effect of high quality nursing intervention on elderly patients with indwelling needles is good, which can effectively calm the emotional fluctuations of patients, enhance their compliance behavior, reduce the incidence of phlebitis, improve the severity of skin redness and swelling.