Background: Spiritual care is an integral component of holistic nursing care, helping patients maintain meaning in life, hope, and inner peace during treatment. However, its implementation in clinical settings remains challenging due to limited nursing competence, heavy workloads, and inadequate organizational support, which may prevent patients’ spiritual needs from being fully addressed. Purpose: To map the scientific evidence on the implementation of spiritual care by nurses in inpatient wards, the factors influencing its implementation, and its effects on patients, families, and nurses. Method: This study employed a scoping review approach based on the Arksey and O’Malley framework, as refined by Levac et al., and adhered to the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. Literature searches were conducted across seven electronic databases for studies published between 2021 and 2025. Study selection was guided by the Population, Concept, and Context (PCC) framework, and the data were analyzed using thematic synthesis. Results: Of the 2,122 articles identified, 14 met the inclusion criteria. The included studies were conducted in various countries and employed quantitative, qualitative, and intervention designs. Thematic synthesis identified five themes: (1) therapeutic presence as the core of spiritual care; (2) spiritual communication as a key approach to its implementation; (3) barriers to implementation, including limited time, heavy workloads, inadequate training, and insufficient organizational support; (4) facilitating factors, including spiritual competence and sensitivity, clinical experience, training, and organizational support; and (5) the benefits of spiritual care for patients, families, and nurses. Conclusion: Spiritual care in inpatient settings is primarily delivered through therapeutic presence and spiritual communication. Its implementation is shaped by individual and organizational factors, with nursing competence, clinical experience, training, and organizational support serving as important facilitators. Strengthening nurses’ spiritual care competencies and improving institutional support may help optimize the delivery of spiritual care in inpatient settings.