目的 开展急诊胸痛患者结构化分诊的临床审查，构建基于证据的审查指标，系统分析障碍因素及促进因素，制订行动策略。 方法 以澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI） 循证卫生保健模式为理论框架，确定临床问题，组建循证团队，系统检索、评价及整合证据，制订审查指标及明确审查方法。在2025年1月1日—3月1日进行临床审查，将证据引入实践策略，分析临床实践过程中存在的障碍和促进因素，并制订相应的变革策略。 结果 共纳入18条最佳证据，制订15条审查指标，其中10条执行率<80%，3条执行率为0。循证实践的主要障碍因素包括胸痛分诊知识不足、分诊超负荷导致动态监测不足、缺乏电子化模板及质控联动机制等；主要促进因素包括管理层支持循证实践、智慧分诊系统具备开发潜力、护理团队专业素养良好并具备学习动机。针对上述因素，制订了结构化电子分诊路径工具建设、护士分层培训与情境模拟、分诊标准纳入质控体系及多学科协作改进等策略。 结论 急诊胸痛结构化分诊的最佳证据与临床现状存在显著差距，需通过标准化路径工具、护士分层培训及信息化建设等策略推动证据转化，提升急诊护理质量。

Objective To conduct a clinical audit on structured triage for emergency chest pain patients，establish evidence-based audit indicators，systematically analyze barriers and facilitators，and develop action strategies. Methods Using the Joanna Briggs Institute（JBI） Evidence-Based Healthcare Model as the theoretical framework，clinical questions were defined，and an evidence-based team was formed to systematically retrieve，evaluate，and synthesize evidence. Audit criteria and methods were developed. A clinical audit was conducted from January 1 to March 1，2025，using the Evidence-Practice Integration Strategy to analyze barriers and facilitators in clinical practice and formulate corresponding change strategies. Results A total of 18 best evidence items were included，and 15 audit indicators were developed. Among them，10 indicators had an implementation rate of <80%，and 3 indicators were 0. Major barriers to evidence-based practice included insufficient knowledge of chest pain triage，insufficient dynamic monitoring due to triage overload，and the lack of electronic templates and quality-control linkage mechanisms. Key facilitators included managerial support for evidence-based practice，the developmental potential of intelligent triage systems，and a nursing team with strong professional competence and motivation to learn. Based on these factors，targeted strategies were formulated，including the development of a structured electronic triage pathway，tiered nurse training with scenario simulation，integration of triage standards into the quality-control system，and establishment of a multidisciplinary collaborative improvement mechanism. Conclusion There is a significant gap between the best evidence and the current clinical status of structured triage for acute chest pain. Promoting evidence translation requires standardized pathway tools，tiered nurse training，and enhanced informatics construction to improve the quality of emergency nursing care.