<p>Coding scheme for independent variables.</p>

Background Telehealth has become an increasingly important approach in healthcare delivery, particularly in improving accessibility, continuity, and efficiency of nursing services. This study investigated the status and influencing factors of telehealth readiness among nurses in Ningxia, China. Methods A multicenter cross-sectional study was conducted from September to December 2024 across 57 public hospitals in Ningxia, utilizing a multistage stratified sampling method. Data were collected through questionnaires that included the Chinese version of the Telehealth Readiness Assessment Tool (TRAT), the Cognitive Telehealth Scale (CTS), the Innovative Behavior Scale (IBS), and the Spiritual Climate Scale (SCS). Statistical analyses included univariate, correlation, and hierarchical multiple linear regression analyses. Results A total of 1000 valid questionnaires were collected. The participants were 33.16 ± 7.17 years, and 951 (95.1%) were female. The mean total scores for telehealth readiness, CTS, IBS, and SCS were 62.29 ± 13.61, 67.75 ± 15.82, 34.85 ± 8.59, and 15.96 ± 3.07, respectively. Hierarchical multiple linear regression analysis revealed that education level, professional title, years of work experience, monthly income, perceived adequacy of the nursing workforce for telehealth services, CTS, IBS, and SCS were all significantly and positively associated with telehealth readiness (all P < 0.05), explaining 51.2% of the variance in telehealth readiness. Conclusion Telehealth readiness among nurses in Ningxia was moderate and influenced by demographic characteristics and psychological factors (cognitive, innovative, and spiritual dimensions). These findings highlight the need for multifaceted interventions that focus on competency building and supportive workplace environments to facilitate telehealth adoption.