Abstract
BACKGROUND: Artificial Intelligence (AI) in nursing practice holds transformative potential for healthcare. For these advancements to be successfully incorporated into nursing, nurses need to develop positive attitudes toward adopting AI technologies. This study aims to profile Chinese nurses’ attitudes toward AI and explore the factors. And introduce NI as a critical antecedent, constructing and validating a chain mediation model involving PEOU and PU, thereby advancing the TAM framework. METHODS: We conducted a cross-sectional study with 765 nurses from four Chinese hospitals. Data analysis included non-parametric tests, Spearman’s correlation, multiple linear regression, and chain mediation testing (using SPSS PROCESS Model 6). RESULTS: ‘The study found that nurses’ attitudes toward AI adoption were significantly influenced by their job hierarchy, knowledge of AI, and perceptions of AI’s importance, usefulness (PU), and ease of use (PEOU), along with frequency of AI usage and nurses’ innovativeness (NI) (p<0.05). PU and PEOU of AI mediated the link between NI and their attitudes toward the use of AI(ATUA). CONCLUSION: Nurses generally held positive attitudes toward AI. The study confirmed a chain-mediation pathway: NI→ PEOU→ PU→ ATUA. These findings extend the application of Technology Acceptance Model in nursing and strengthen its predictive power in this context. This study provided a theoretical foundation for fairly promoting and implementing AI in nursing practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-026-04399-0.