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Time to antibiotics is critical in febrile neutropenia, and nurse-initiated protocols can reduce delays. Safe, compliant implementation requires formal, approved standing orders with well-defined triggers (e.g., temp ≥38.0°C in a chemotherapy patient), scope (cultures, lactate, IV fluids, antipseudomonal β-lactam), and explicit exclusion criteria (instability, allergy, indwelling line infections). Competency-based training, simulation, and annual validation ensure reliability. APRN/physician oversight, real-time availability, and audit/feedback (door-to-antibiotic time, cultures-before-antibiotics) maintain quality. Ad hoc actions (Option A) risk variability and liability; automatic antibiotic release (Option C) without assessment is unsafe. Restricting all steps to APRNs (Option D) may prolong delays and ignores team-based care models. The APRN co-leads policy design, metrics, and continuous improvement.