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Healthcare associated infections remain a significant threat to patient safety in pediatric wards, contributing to increased morbidity, mortality, prolonged hospitalization, and rising healthcare costs. Children are particularly vulnerable due to immature immune systems, frequent exposure to invasive devices, and close contact caregiving environments. This article examines the scope, implementation, and outcomes of nurse led initiatives for infection prevention in pediatric settings over the past decade. Drawing on contemporary evidence and global guidelines from organizations such as the World Health Organization and the Centers for Disease Control and Prevention, the review synthesizes strategies including hand hygiene promotion, central line and ventilator care bundles, antimicrobial stewardship participation, environmental hygiene audits, surveillance systems, technology integration, and family engagement programs. Nurse led quality improvement collaboratives and standardized maintenance protocols have demonstrated measurable reductions in central line associated bloodstream infections, ventilator associated pneumonia, and other healthcare associated infections in pediatric wards. The article also discusses economic benefits, implementation barriers, leadership implications, and sustainability frameworks that support long term success. Evidence indicates that nurse leadership is central to establishing a culture of safety, enhancing compliance with evidence based practices, and improving patient outcomes. Strengthening nurse autonomy, education, and institutional support is essential to sustain infection prevention gains and to address emerging challenges such as antimicrobial resistance and technological integration in pediatric healthcare environments.