The aim of this quality improvement practice project was to improve noted delays in the time to antibiotic administration in paediatric febrile neutropenic patients seen at King Faisal Specialist Hospital and Research Centre (KFSH&RC), Saudi Arabia. Larrabee’s 6-step Model for Change of evidence-based practice guided the project. Clinical audit, nursing knowledge survey, comprehensive literature and international clinical guideline review were used to identify and design a clinical care pathway for paediatric febrile neutropenic patients at KFSH&RC. Post-implementation clinical audit showed a reduction in time to antibiotic administration and increased self-efficacy and knowledge among nursing staff in relation to managing the care of febrile neutropenic patients. This reflects similar improvements seen internationally in other centres following the introduction of a clinical pathway. This nursing led practice change was the first of its kind for KFSH&RC. It demonstrated that with support from key stakeholders, Larrabee’s model for evidence- based practice change can be used for introducing a nurse-led clinical care pathway in Saudi Arabia. Highlights •A new clinical care pathway introduced in Saudi Arabia improved time to antibiotic administration in paediatric febrile neutropenic patients. •Implementing a nurse-led clinical care pathway increased nurses’ confidence with managing children with febrile neutropenia and the skills and knowledge related to the accessing and delivering medication via central access devices •With key local stakeholder support evidence-based change frameworks such as that proposed by Larrabee can be used to improve nursing management in Saudi Arabia.