This project was was something that I originally began in order to fulfill a course requirement but turned into a project that affected both how I see the Mother-infant Dyad and realizing the potential for change and growth at my place of employment. I met with my boss (manager) Nancy Brett in early March of 2017 to discuss if she would be open to me presenting this topic to my co-workers. She was receptive to the idea, and the initial thought was that I would prepare a power-point and offer a couple in-services, one for day shift and one for night shift. The problem was our unit is currently under construction and our education room is part of the area off limits, but she was confident it would be done in time for me to present in early April. As April came and advanced it was obvious this was not going to work, so I tweaked the idea. I conducted a pre-presentation quiz among 12 co-workers ( six from nights, and six from days) to guage what areas of the BFI/Supporting the Mother-Infant Dyad needed to be addressed. I still prepared the powerpoint, but I also prepared a presentation board as to reach more co-workers than those who my schedule coincides with. From the pre-presentation quiz I was surprised to learn that 58% of the respondents had never heard of the Baby Friendly Initiative. A combination equaling 57% of either "yes" or "I don't know" responses indicated that my co-workers were misidentifying the terms "Baby Friendly" and "Couplet Friendly" to mean the same thing. 91% of my co-workers believed breastfeeding the superior choice for the newborns we care for and 91% also reported they did not judge moms who requested their newborns be taken to the nursery so they could rest. This last statistic was surprising based upon interactions I have had with my co-workers regarding this topic in the workplace. 70% did not feel how we care for our mother's could be linked to post-partum depression later on. 56% Mis-identified or were not sure of MRMC's Baby Friendly status. The only unanimous response was that none of my co-workers felt the current HCAHP scores reflected the care we were striving to provide to our patients.

Next I prepared a power-point addressing these areas and then presented it to my manager. We discussed the power-point in her office and I was given the go-ahead to move forward.

I did and oral presentation over the powerpoint material on 4/17/17 during day shift and 4/20/17 for night shift. I met with our lactation consultant to see if she would be willing to offer lactation inservices for our nursery and L&D staff and she was more than willing. She also agreed to train us on how to initiate breastfeeding assistance devices so we could support our mothers/infants needs when lactation was not working. During the week of 4/17-4/22 I left a presentation board in my unit's breakroom that provided the pre-quiz results, had a copy of the powerpoint material, and the post quiz. On the days I wasn't working I would look at the schedule and text both day and night shift workers to please review the material if the shift's acuity allowed. During the days I worked I would do a short speech during am/pm huddle as well.

I was expecting a lot of opposition, negative attitudes, and eye rolls from my co-workers when disseminating the information but the result was the opposite. The project produced a lot of positive feedback and got us talking among ourselves about ways to improve our patient care, unit comradery, and HCAHP scores. Almost all the nurses agreed that we needed to improve our teamwork with our sister units and that evidence based care was being under utilized on our unit.

I presented the quiz statistics to my manager who was pleased with the feedback, she called me into her office and asked me if I would be willing to present the material to the nursery staff in the near future too and get the ball rolling to form a UBC, since there was a lot of interest in this intervention.

What started out as "just another school project," seems to have transformed into something I will be utilizing quite a bit in the days ahead and hopefully contribute to a positive transformation of care for our patient population.