急诊胸痛患者结构化分诊审查指标的制订及障碍与促进因素分析

doi:10.3761/j.issn.2096-7446.2026.04.015

Abstract

Abstract:

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.

Key words: Chest Pain, Emergency, Triage, Audit Criteria, Barriers, Evidence-based Nursing

HU Ziwei, OUYANG Lanxin, KE Haiming, LIN Yin, LIU Di. Development of audit indicators for structured triage of emergency chest pain patients and analysis of barriers and facilitators[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 469-475.

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References 27

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Development of audit indicators for structured triage of emergency chest pain patients and analysis of barriers and facilitators

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