Purpose: The purpose of this study was to identify registered nurses learning needs about physical assessment. Specifically, what are the perceived competency, frequency of skill use and the unmet training needs. Methods: The study was an exploratory survey study. The sample was 104 registered nurses. Data were collected through three instruments: The Perceived Competency in Physical Assessment Scale, the Frequency of Physical Assessment Scale, and the Training Needs of Physical Assessment Scale which incorporated 30 core Physical Assessment skills. Descriptive statistics, t-test, and Pearson's correlation coefficient were used to analyze the data. Results: Auscultation of heart and lung sounds and inspection of the spine were rated by the subjects as physical assessment skills they feel least competent and also were less frequently performed. The most competent area for physical assessment was neurological system. The respiratory and abdominal system was identified as two systems that more education would be needed. Nurses with less than one year of working experience reported needing more training. Nurses with more than five years of clinical work experience performed physical assessment more frequently than nurses with less than five year of work experience. The perceived competency was positively related to the frequency of physical assessment. Conclusion: Continuing education is necessary to further train registered nurses regarding physical assessment skills and the program needs to be focused on the area which nurses are less competent for and have high training need.

The purpose of this study is to analyze the factors affecting breastfeeding initiation by time sequences after delivery. We retrospectively reviewed medical records of the mothers and neonates in 22 hospitals with over 500 beds selected by proportional stratified random sampling according to location and bed size. We randomly sampled 60 cases per each delivery type (vaginal delivery and C-section) from each hospital, from the patients who had discharged between September 1st and November 30th, 2006. If there were no enough sample size in one hospital, we reviewed all cases during discharged 3 months period. A total of 1,506 medical records were selected but 281 were excluded because of breastfeeding contraindication (54 cases), refusal of breastfeeding(187 cases), and no breastfeeding initiation time record (40 cases). Total number of subjects included for analysis was 1,225. We reviewed breastfeeding initiation time after delivery and conducted Chi-square test and multiple logistic regression analysis. Seven variables (maternal age, delivery type, gestational age, birth weight, 5 minutes APGAR score, mother's hospital duration, and Baby-friendly Hospital Initiative) were used in multiple logistic regression analysis. Multiple logistic regression was carried out using SPSS WIN 12.0 program to identify the factors affecting initiation time of breast feeding. The proportion of mothers who breastfed within 30 minutes after delivery was 12.3% in vaginal delivery and 0% in C-section. Adjusted odds ratios associated with no breastfeeding within 120 minutes after delivery were 0.04(95%

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