Objective To explore effective management strategies to improve the outcome of hospitalized children in a large tertiary neonatal intensive care unit (NICU). Methods We converted the nursing care delivery model from primary nurse in charge to colla-borative nursing care team-driven since 2014. In the new model, intra-hospital transport and respiratory treatments were provided by nurses designated for specific posts, and clinical nurse specialists-driven micro-specialty teams were formed to solve specialty-specific problems. Results Until 2019, 7 micro-specialty teams were set up, including enteral and parenteral nutrition, vascular access, skin (wound & stoma), respiratory management, infection prevention and control, caring for very low birth weight (VLBW) infants, and nursing education. The incidence of ventilator-associated pneumonia, nosocomial infection and mortality in VLBW infants, as well as PICC-associated bloodstream infection decreased year by year (P＜0.01 for all). Breastfeeding rate of VLBW infants and parents′ satisfaction increased year by year (P＜0.01 for both). Conclusion Modifying nursing care delivery model and practicing micro-specialty team in large tertiary NICU can enhance outcomes of infants and satisfaction of parents.