Neonatal Resuscitation Program (NRP): 5 Changes to Come

| Roxanne Blanford

Though 90% of newborns experience no difficulty in transitioning to life outside the womb, an estimated 1% of neonates require intensive, life-saving resuscitative intervention. These critically-ill infants deserve neonatal nurses and obstetric care staff who are competent in proper and effective newborn CPR, neonatal resuscitation, and stabilization procedures. 

In 1987, the Neonatal Resuscitation Program (or, NRP) "was address the increasing need for an educational program focusing on initial management of newborns requiring transfer to the NICU." 

Within just a few years time, NRP was successfully meeting the training needs of neonatal healthcare educators and learners throughout the United States and Canada.  As of 2017, "over 4 million healthcare professionals have been trained or retrained (in NRP protocols), across 130 countries."

NRP: Advancing Training in Newborn Baby Resuscitation


The NRP has set the standard for training in neonatal resuscitation for more than 2 decades. Part of this success is attributable to its ability to adapt to the ever-changing needs of its instructors and trainees."

As NRP practices continue to evolve, both in content and in process, the need to advance the development of a career-long learning program in neonatal resuscitation remains paramount. Some of the changes neonatal nurses can expect from NRP advancements include these five elements: 

  1. Extending evidence-based practice to education and training practices

  2. Adopting strategies that follow from adult learning theory

  3. Encouraging development of challenging training experiences

  4. Accepting failure during these experiences so trainees may learn from their mistakes

  5. Embracing high-fidelity, high-stakes simulation-based training as the standard in preparation for, and assessment of, performance in the real environment

The Value of Simulation Training in Neonatal Resuscitation

Simulation-based training, where trainees are immersed in highly realistic re-creations of actual real-life clinical events, will play a major role in the evolution of NRP. This type of training has been used successfully for decades in a number of other industries where the risk to human life is high."

Recommendations abound to make hands-on, simulation-based training in newborn resuscitation a required part of continuing education in healthcare due, in part, to the fact that some skills tend to erode over time when not re-invigorated by repeated practice.

Mastering the skillsets needed for successful resuscitation of a neonate (the ability to interpret sensory cues that neccesitate appropriate clinical interventions, for example) demands a thorough understanding of when and how to call upon those skills. It is possible to obtain, hone, and maintain resuscitation skills by training with innovative technologies, such as infant patient simulation.

While a number of human neonatal patient trainers historically have lacked suitable fidelity, and/or have not accurately represented infant physiology to be effective training tools, the new CAE Luna infant patient simulator (from CAE Healthcare) is uniquely designed to offer end-users the widest range of options to help them meet specific and progressive training needs.

Meet CAE Luna

The CAE Luna baby simulator is a highly realistic patient simulator with the right combination of advanced technology (SymDefib external defibrillator box; dynamic airway resistance; external lung; tracheostomy site; mechanical ventilation support*) and user-friendly software to allow acquisition, development and refinement of essential skills for successfully resuscitating a newborn baby.

CAE Luna is available in three patient configurations (Base, Live, Advanced), giving neonatal healthcare training facilitators everything they need to achieve their educational objectives.

Neonatal nurses are a vital link in the chain of infant and newborn healthcare. Not only do they recognize the early signs of a baby's deteriorating health, and act quickly to prevent cardiac arrest or initiate immediate life support measures, but nurses who work with sick neonates also play a special part in tending to the needs of the little patient's loved ones during cardiopulmonary resuscitation emergencies.

The very least we can do is to offer these dedicated professionals high-quality training solutions to help them perform at their best. 


American Academy of Pediatrics. Neonatal Resuscitation Program Textbook. 5th ed. 2006

Educational Perspectives: The Genesis, Adaptation, and Evolution of the Neonatal Resuscitation Program.  Amer Acad of Pediatrics; April 2008 



Summary :

The next decade will bring even more substantial methodologic and technologic innovations as the NRP becomes more learner-focused and learner-friendly and embraces methodologies such as simulation and technologies such as online libraries of interactive case-based scenarios. This continuing evolution of NRP should make it even more useful to the practicing neonatologist as a source of continuing medical education and career-long learning




*Note: some features listed may not be available on each Luna configuration. Contact CAE for details.

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