The “5E” hierarchical nursing strategy: Improving catheter outcomes, patient satisfaction, and self-management in oncology day-care settings

Peripheral venous catheters (PVCs) are commonly used in day-care oncology settings, but catheter occlusion and related complications can negatively affect both patient experience and nursing quality. Therefore, exploring effective nursing strategies to minimize complications, enhance satisfaction, and strengthen patients' self-management skills is of significant clinical value. This retrospective controlled study involved 286 oncology patients receiving PVC infusions in the day ward between March and August 2021. Based on admission period, patients were assigned to 2 groups: 142 patients admitted from March to May received routine nursing care (control group), while 144 patients admitted from June to August were managed under a hierarchical "5E" nursing strategy (observation group). The 5E strategy comprised Evaluation, Education, Environment optimization, Engineering control, and Execution enhancement. Outcomes compared between groups included baseline characteristics, catheter occlusion rate, mean indwelling time, nursing satisfaction, self-management ability, and incidence of adverse events. Baseline characteristics were comparable (P > .05). The observation group demonstrated a lower occlusion rate (4.9% vs 13.4%, P = .014), longer average indwelling duration (4.85 ± 1.13 vs 4.32 ± 1.05 days, P < .001), and higher nursing satisfaction (95.1% vs 85.2%, P = .008). Self-management scores were also significantly higher (87.6 ± 6.8 vs 80.9 ± 7.5, P < .001), particularly in execution ability and symptom recognition. Additionally, adverse event incidence was lower in the observation group (6.3% vs 14.1%, P = .029). The hierarchical management-based "5E" nursing strategy effectively reduces PVC occlusion and adverse events, extends indwelling time, and improves both satisfaction and self-management among oncology day-care patients. This approach shows strong potential for wider clinical adoption.