What is NRP and who is required to have it?
The Neonatal Resuscitation Program is the American Academy of Pediatrics' education programme for resuscitation of the newborn at birth, developed with the American Heart Association. It teaches the neonatal resuscitation algorithm — rapid evaluation, initial steps of newborn care, positive-pressure ventilation and the ventilation corrective steps, chest compressions, intubation and laryngeal mask use, medications and volume, and post-resuscitation care — together with the team behaviours that make resuscitation work. The current course is blended: an online examination and case-based learning followed by an instructor-led session built around simulation and structured debriefing rather than lecture. Completion is recorded on a two-year cycle. Hospitals require NRP for clinicians who attend deliveries, which in practice means neonatal and labour-and-delivery nurses, respiratory therapists, midwives, paediatricians, neonatologists, anaesthesia staff and neonatal transport teams.
- NRP is the American Academy of Pediatrics programme for resuscitation of the newborn at birth, developed with the American Heart Association.
- The course is blended: an online examination and case-based learning, then instructor-led simulation and structured debriefing.
- Effective positive-pressure ventilation is the central skill, because most newborns who need help need help breathing.
- Completion runs on a two-year cycle and is required by hospitals for anyone attending deliveries.
NRP at a glance
| Cost | Set by the hospital or training centre running the instructor-led part, plus the online component's own fee, so it varies by provider — check with your instructor |
| Duration | Self-paced online component followed by an instructor-led simulation session, typically a few hours |
| Issued by | American Academy of Pediatrics (developed with the American Heart Association) |
| Format | Blended: online exam and case-based learning, then in-person simulation and debriefing with an NRP instructor |
| Expiry | 2-year cycle |
| Who needs it | Anyone who attends deliveries: neonatal and labour-and-delivery nurses, respiratory therapists, midwives, paediatricians, neonatologists, anaesthesia and neonatal transport teams |
| Emphasis | Positive-pressure ventilation — the single most important intervention in newborn resuscitation |
| Assessment | Online examination plus performance in simulation, with structured debriefing |
Sources: American Academy of Pediatrics, Neonatal Resuscitation Program · American Academy of Pediatrics. Reviewed August 2026 by the GlobalCybers team.
NRP Course Format, Online Plus Simulation
Learning moved out of the lecture room
NRP deliberately puts the knowledge component online — an examination and case-based learning completed before you attend — so that the instructor-led time is spent on simulation and structured debriefing rather than slides. Performance is assessed in simulated resuscitations, and the debriefing that follows each one is treated as part of the education, not an afterthought. That design reflects the evidence that resuscitation skill decays without practice.
Course structure
How does NRP affect perinatal nursing and EMS roles?
NRP is a condition of attending deliveries rather than a wage grade. Its practical effect is on unit access: labour and delivery, newborn nursery, NICU and neonatal transport all require current completion.
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What NRP Covers, The Newborn Algorithm
Positive-Pressure Ventilation
The central intervention of newborn resuscitation. Mask seal, rate and pressure, assessing whether the chest is moving, and the corrective steps to run when it is not — this is where most newborn resuscitations are won or lost.
Preparation & Anticipation
Identifying perinatal risk factors before delivery, assembling the right team, and checking equipment — because the newborn who needs resuscitation is frequently not the one anyone expected.
Compressions & Coordination
When compressions are indicated, the technique and ratio used in newborns, and coordinating them with ventilation so that neither is compromised.
Medications & Volume
Indications, routes and dosing for the medications used in newborn resuscitation, and recognising the specific circumstances in which volume expansion is appropriate.
Team Behaviours
Role clarity, closed-loop communication, calling for help early and speaking up — the behavioural skills the programme treats as clinical skills, assessed in simulation.
Debriefing
Structured debriefing after each simulation, and the practice of debriefing real resuscitations. The programme treats reflection as part of the intervention rather than an optional extra.
How do you complete NRP, step by step?
Complete the online examination and case-based learning
The knowledge component is completed first and independently, so that the instructor-led session can be spent on practice. Doing it properly rather than clicking through matters: the simulation session assumes you already know the algorithm.
Attend the instructor-led simulation session
Run by an NRP instructor, this is where you perform in simulated resuscitations, practise the hands-on skills — mask ventilation above all — and take part in structured debriefing. It is the part employers cannot waive.
Demonstrate performance in simulation
Assessment is based on performance in simulated resuscitation, including both the technical algorithm and the team behaviours. The programme's design assumes that competence is demonstrated by doing, not by answering questions about doing.
Repeat on the two-year cycle
Completion is recorded on a two-year cycle and hospitals track it through credentialing. Because skill decay in infrequently used resuscitation techniques is well documented, many units supplement the formal cycle with more frequent in-situ drills.
Required for Anyone Attending Deliveries
NRP is not a statutory licence. It is a hospital and professional expectation, and a strong one: birthing units require that personnel capable of initiating newborn resuscitation be present at every delivery, which in practice means current NRP completion for the clinicians who attend. Credentialing offices track it alongside BLS and, for many staff, PALS. An expired record generally removes a clinician from the delivery roster until it is renewed.
NRP, Frequently Asked Questions
NRP current? Perinatal units need you.
Labour and delivery, NICU and neonatal transport teams require current NRP. Set your intent and let them find you.
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