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Marking 35 years, NRP has trained almost 6 million providers

July 1, 2022

With millions of health care professionals trained in the Neonatal Resuscitation Program (NRP) over the past 35 years, it’s impossible to know how many lives have been saved as a result of the training.

Each one is a testament to an enduring program now taught in more than 130 countries.

Gary M. Weiner, M.D., FAAP, editor in chief of the 7th (2016) and 8th (2021) editions of the Textbook of Neonatal Resuscitation, never tires of receiving resuscitation success stories.

“I get text messages and emails from (former) trainees of mine who had a particularly challenging resuscitation in the delivery room,” Dr. Weiner said.

The trainees share outcomes with him, noting how a technique used in an NRP course made a difference.

“When I get those emails, it’s still something that is always exciting,” said Dr. Weiner, who also directs the neonatal-perinatal fellowship program at University of Michigan.

Since its inception, NRP has achieved milestones, including the following:

  • 5,730,000 trained providers,
  • 397,000 active providers today,
  • 18,500 active instructors,
  • 24 language translations of the NRP textbook and
  • 200,000 professionals completing the course every year.

“As health care providers go to work in the delivery room, what they’ve learned in NRP is immediately applicable to what they have to do,” Dr. Weiner said.

NRP’s evolution

When NRP launched at the 1987 AAP Annual Meeting, it had no official staff and no budget.

As a result, a lot of challenging work was in store for AAP staff and volunteers, William J. Keenan, M.D., FAAP, told AAP News at the time. He became one of nine founding members of the NRP Steering Committee and has taught the program in multiple countries.

A joint program of the AAP and American Heart Association (AHA), NRP grew out of a need for a standardized curriculum. It is based on the evidence-based American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care.

The recognition in the 1970s that newborns were different and required a unique approach and teaching program for resuscitation was a key step along the path, Dr. Weiner said.

“It’s a very special teaching program. It addresses a very specific need — a really important need,” said Dr. Weiner, noting the unique physiology of newborns.

“You can be confident as you’re reading new recommendations and following the textbook that the recommendations that are there — the guidelines, the approach to resuscitation — have been evaluated for evidence,” he said.

Former AAP Executive Director Errol R. Alden, M.D., FAAP, a pioneer of the program, helped forge the collaboration with the AHA and other organizations when he was director of the AAP Department of Education.

Recommendations in the first edition textbook (1987) were based largely on expert opinion, said Jeanette Zaichkin, R.N., M.N., NNP-BC, associate editor of the textbook since 1998. Beginning in 1992, the AAP joined the AHA at a series of international conferences, where the International Liaison Committee on Resuscitation reviews the scientific evidence using a rigorous evidence evaluation process. The evidence-based guidelines now are co-written by AHA and AAP members with expertise in evidence evaluation and neonatal resuscitation.

Continuous improvement

“I think the reason it’s lasted for 35 years and has been so successful is that the NRP Steering Committee has had an ability to keep health care providers engaged in learning and interested in neonatal resuscitation,” Zaichkin said.

The committee also has kept up with technology and adult learning methodologies, added Zaichkin, NRP consultant and editor of the online NRP Instructor Toolkit.

NRP is the “translation of the science into clinical practice,” she said.

Along with the science, the educational approach has evolved.

“It’s interesting as you follow the course of the NRP textbook how it has reflected changes in technology,” Dr. Weiner said.

The current textbook incorporates technologies including QR codes that can be scanned with a mobile device to see videos demonstrating key skills. The program also has evolved to meet the needs of learners at different levels and who are practicing in different situations, Dr. Weiner noted.

Over the years, patient simulators also became available, allowing NRP to become the first life support program to pioneer the incorporation of simulation and debriefing. More recently, a newer NRP learning platform was introduced and hosted by RQI Partners. The new RQI for NRP cart allows for episodic, low dose/high frequency practice of the critical lifesaving skill of neonatal resuscitation: bag-mask ventilation.

Experts agree the program has come a long way since the original version that used a paper-based text and evaluation.

NRP “went from an idea that thoughtful, bright people essentially had in the 1970s and developed into a really well thought-out and well-designed program … and has become the educational standard for 35 years,” Dr. Weiner said. “There are not many programs that can boast that and have stood the test of time. …”

To celebrate the anniversary, the AAP will hold a reception Oct. 7 at the 2022 National Conference & Exhibition in Anaheim, Calif., in conjunction with an NRP Current Issues seminar (

A digital timeline of NRP history will be on display at AAP headquarters, along with a special exhibit.



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