Background: Central lines and PICCs are essential in NICU care but carry risks such as
CLABSI, thrombosis, and mechanical complications, particularly in preterm neonates. Simulationbased education, especially using virtual reality (VR), provides an immersive learning environment
for NICU nurses to develop critical skills safely. VR training strengthens nurses’ skills, infection
prevention, and clinical judgment, promoting safer and higher-quality neonatal care. Aim of the study
was to evaluate the impact of VR simulation-based education on nurses’ knowledge, practices, and
satisfaction in preventing central line-associated bloodstream infections in neonates. Study design: A
quasi-experimental research design (study & control groups/ pretest & posttest) was utilized. Setting:
The study was conducted in the Neonatal Intensive Care Units of Benha University Hospital and the
Specialized Pediatric Hospital at Benha City. Study subjects: A purposive sample of 98 NICU nurses
was divided into study and control groups in each hospital based on work schedules, with the study
group receiving lectures plus VR simulation and the control group lectures only Tools of data
collection: Three tools were used; Tool I: A structured interviewing questionnaire which divided into
two parts: Part (1) Nurses' characteristics and Part (2) Nurses’ Knowledge regarding infection control.
, Tool II: (An observational checklists) pre and posttest which consisted of three parts: First part
(Handwashing checklist), second part (Administration of Intralipid Solution checklist) and third part
(Dressing change checklist) and Tool III: Nurses’ satisfaction Scale (posttest). Results: Both groups
were similar before the intervention, with no significant differences and no prior exposure to VRbased education. The simulation significantly enhanced knowledge and practice levels in the study
group compared to the control group, and the majority of studied nurses reported high satisfaction.
Practice was associated with several demographic variables before the intervention and only with
education level afterward, with strong positive correlations between knowledge, practice, and
satisfaction (p < 0.001). Conclusion: Virtual reality simulation-based education represents a
promising strategy in enhancing nurses’ knowledge, improving their clinical practice competence, and
increasing their satisfaction levels regarding Prevention of CLABSI in neonates. Recommendations:
Incorporating regular VR simulation training for nurses to strength knowledge and skills in CLABSI
prevention and Implementing VR-based pre-clinical assessments to verify nurses’ competence before
performing NICU central line procedures.