Background: The current study aims to audit the current care of newborns in the NICU in comparison with the previous year(treating consultant discretion versus Unit–protocol based approach). Methods: The current study was carried out at NRI medical college, in the period from May 2016 to April 2017 (treating consultant discretion) and May 2017 to April 2018(Unit protocol based approach).In the present work all data was collected retrospectively through the clinical records for May 2016 to April 2017 and prospectively between May 2017 to April 2018. Results: Triage, antibiotic stewardship and outcomes improved with predefined protocols. Conclusions: Application of unified protocol is important for optimum care in NICU. Conducting such audits, help identify areas that have improved and could be improved, to improve outcomes in NICU