Objective To investigate the current status of self-efficacy in delirium nursing care among newly recruited intensive care unit (ICU) nurses and identify its influencing factors, thereby providing evidence for the development of targeted training programs. Methods A total of 336 newly recruited ICU nurses from nine tertiary Grade A hospitals in Shanghai were conveniently recruited as study participants. Data were collected using a general information questionnaire, the Delirium Care Self-Efficacy Scale, and a Delirium Knowledge Questionnaire. Results The mean total score for self-efficacy in delirium nursing care among newly recruited ICU nurses was 36.28 ± 8.09. Multiple linear regression analysis showed that age, educational level, department, participation in delirium-related training, and delirium knowledge level were significant factors influencing self-efficacy in delirium nursing care among newly recruited ICU nurses (all P<0.05), collectively explaining 75.3% of the total variance. Conclusion The overall level of self-efficacy in delirium nursing care among newly recruited ICU nurses was relatively low to moderate, with particular deficiencies in delirium assessment. Nursing managers may enhance nurses′ self-efficacy in delirium nursing care through comprehensive delirium education, delirium subtype recognition training, and experiential teaching strategies such as simulation-based training.