Objective To evaluate the feasibility and effectiveness of implementing a continuous improvement of the pre‐examination process based on evidence‐based nursing concept in the management of acute chest pain in adults. Methods Based on the inclusion and exclusion criteria, the 92 cases of acute chest pain patients who aged ranging from 18 to 75 years old were admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from December 2022 to December 2024 and were allocated by admission date into the control group ( n = 46) and the observation group ( n = 46). The control group received routine pre‐examination and triage, while the observation group underwent continuous improvement of the pre‐examination process based on evidence‐based nursing concept. The waiting time, consultation time, triage duration, triage accuracy rate, misdiagnosis rate, missed diagnosis rate, revisit rate, complaint rate, rescue success rate, and patient satisfaction were compared between the two groups. Results The waiting time, consultation time, and triage duration in the observation group (4.45 ± 1.21 min, 2.08 ± 0.44 min, 1.56 ± 0.37 min) were shorter than the control group (5.61 ± 1.08 min, 2.97 ± 0.25 min, 2.52 ± 0.42 min) ( t = 4.851, 11.928, 11.632, p < 0.05). The triage accuracy rate in the observation group was higher than the control group (95.65% vs 80.43%, χ 2 = 5.059, p < 0.05). The misdiagnosis rate, missed diagnosis rate, and complaint rate in the observation group were (4.35%, 2.17%, 2.17%) lower than the control group (17.39%, 17.39%, 17.39%) ( χ 2 = 4.039, 6.035, 6.035, p < 0.05). The rescue success rate and patient satisfaction in the observation group (97.83%, 95.56%) were higher than the control group (84.78%, 79.49%) ( χ 2 = 4.929, 5.144, p < 0.05). Conclusion The implementation of an evidence‐based continuous improvement program for the pre‐examination process was associated with enhanced triage accuracy, reduced diagnostic errors and complaints, and improved rescue outcomes and patient satisfaction in adult patients with acute chest pain. These findings support the feasibility and potential clinical value of integrating structured, evidence‐guided processes into emergency triage workflows.
Gan et al. (Thu,) studied this question.