Background: Digital technologies are increasingly embedded in nursing documentation, communication, monitoring, education, decision support, and patient engagement. Their successful implementation depends on workforce knowledge, perceived usefulness, usability, facilitating conditions, ethical confidence, and behavioural intention. This study assessed technology readiness, acceptance, barriers, and ethical concerns among nursing professionals in Mahabubnagar district, India.

Methods: A multicentre institution-based cross-sectional convergent mixed-methods survey included 532 nursing professionals from selected teaching hospitals and nursing colleges. The instrument assessed sociodemographic characteristics, awareness/use of 10 technologies, digital-health knowledge, a 30-item acceptance/readiness scale, barriers, and open-ended perspectives. Descriptive, psychometric, bivariate, correlation, multiple linear regression, and multivariable logistic regression analyses were specified, high acceptance was defined as 120-150.

Results: Digital-health training was reported by 40.0%, EHR use by 30.1%, and mobile-health use by 40.0%. Mean acceptance/readiness was 115.9 ± 20.8, 47.7% had high, 40.4% moderate, and 11.8% low acceptance. The acceptance scale showed high internal consistency (α=0.938). Lack of training (69.2%), technical support (64.1%), poor connectivity (62.8%), and lack of institutional policy (62.4%) were leading barriers. In adjusted models, training, EHR use, mobile-health use, internet availability, knowledge, and qualification were positively associated with acceptance, whereas barriers were inversely associated. The logistic model reported an AUC of 0.874 (95% CI 0.844-0.902).

Conclusion: Nursing professionals showed favourable willingness to use digital technologies, but implementation readiness was limited by uneven training, practical exposure, infrastructure, and organisational support. Digital transformation should combine competency-based training, reliable systems, technical support, and explicit ethical governance.