·       Reduction in Central Line-associated Bloodstream Infections (CLABSI) in neonates admitted to NICU from 25 /1000 line days by 25% at a tertiary care hospital over a period of six months and sustain over nine months.

·       This prospective QI study was conducted over 16 months in a tertiary NICU. A multidisciplinary team implemented sequential interventions using the Point-of-Care Quality Improvement (POCQI) methodology and Plan–Do–Study–Act (PDSA) cycles. Interventions included improvement in hand hygiene, central line maintenance (scrub-the-hub), and intravenous fluid preparation using aseptic non-touch technique (ANTT) under laminar airflow. Outcome measures were CLABSI rate per 1000 line days and blood culture positivity. Process indicators included hand hygiene and bundle compliance. Data were analysed using run charts.

·       A total of 237 neonates were included. Baseline CLABSI rate was 25/1000 line days, which reduced to 11.4/1000 line days (54.4% reduction). During the sustenance phase, rates remained below baseline (9–11.4/1000 line days). Hand hygiene compliance improved from 0% to ~70%, and scrub-the-hub compliance to 62%. Blood culture positivity decreased from 36.1% to 16.3%, and antibiotic utilization ratio reduced from 1.67 to 0.88. Improvements were sustained despite operational challenges.

·       Structured, low-cost QI interventions using POCQI methodology significantly reduced CLABSI rates and improved infection control practices. Sustained reduction requires continuous monitoring, team engagement, and reinforcement of best practices.

CLABSI rates reduced from 25 to 11.4 per 1000 central line days (54.4% reduction) at our tertiary care hospital over a period of 13 months and sustained over 5 months. Improvement in knowledge, attitude and practice of hand hygiene, adherence to proper central line care bundle, and preparing IV fluids by aseptic non touch technique (ANTT) paid rich dividend in reduction of CLABSI. Reduction in CLABSI led to overall reduction of infection and antibiotic utilization. Blood culture positivity reduced from 36.1% to 16.3 %, with significant improvement observed in inborn neonates from 29.6% to 11.6%. Antibiotic utilization ratio (AUR) reduced from 1.67 to 0.88 with significant improvement observed in inborn neonates from 1.76 to 0.66. In conclusion, simple and low-cost interventions using POCQI approach led to significant reduction in CLABSI in our NICU. Regular monitoring, feedback, and teamwork were essential to sustain the changes.