We made the change at our hospital several years ago. Knowing that people hate change we started with inviting the nurses from labor/delivery, post-partum and Nicu to attend. At the meetings we reviewed all the literature that demonstrated how this would be beneficial for our patients. Based the the knowledge that nurses want to do what is best for thr patient but have to be given the evidence to support the change, we thought this was important. Each week as a team we discussed how we could accomplish the sacred hour. Since all areas were represented, they were able to voice their opinions on what would work or what we needed to do to make it work. Along the way we did have some episodes of hostility but they were resolved with team effort. After several months of meetings, we had a plan in place with all the kinks worked out. At this time the plan was presented to OB and PEDS Committee for physician buy-in. Since we already had our plan in place, we were able to respond with evidence based studies and how it would work. After physician buy-in, it was presented at the department staff meetings and professional practice council. Our next step was a day of a trial run to see how things went. We then made a celebratory day of our kick-off with posters, balloons etc. Another part of this was the patient education flyer that described the benefits of the skin to skin and our new policy. We had some push-back from some staff initially but not very much since they realized this was the new norm. My best advice for you for success is the involvement of the nurses from each area so they have an invested interest in the success. I believe if you do this, the answers to how it will flow will be worked out. I hope this helps, the process is well worth the outcome.
Take care, Sheila Dedrick, MSN,RN,IBCLC

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