Authors

  1. Zaichkin, Jeanette MN, RN, NNP-BC
  2. Kamath-Rayne, Beena D. MD, MPH, FAAP
  3. Weiner, Gary MD, FAAP

Abstract

Background: Approximately 10% of newborns need assistance at birth, and an evidence-based, timely, and coordinated response is critical to optimal outcome. The Neonatal Resuscitation Program(R) (NRP(R)) is the training and education standard in the United States for healthcare professionals who manage newborns in the hospital. This article summarizes the development of evidence-based resuscitation science, changes in the NRP 8th edition educational methodologies, and several significant practice changes made for educational efficiency and patient safety.

 

Evidence Acquisition: The NRP 8th edition is informed by multiple systematic reviews of emerging science conducted by the International Liaison Committee on Resuscitation (ILCOR), which culminates in consensus documents on resuscitation science. The American Academy of Pediatrics (AAP) and the American Heart Association (AHA) used these recommendations to develop the most recent neonatal resuscitation guidelines for North America. These guidelines inform the NRP 8th edition practice recommendations.

 

Results: The most recent CoSTR (Consensus on Science with Treatment Recommendations) summary and AAP/AHA guidelines for neonatal resuscitation yielded no major changes in practice. However, scientific research over the past 5 years resulted in new and higher grades of evidence to support previous recommendations. The NRP Steering Committee revised several practices in the interest of patient safety and educational efficiency.

 

Implications for Practice: The NRP 8th edition materials were released in June 2021 and must be in use by January 1, 2022. In the new ILCOR evidence review format, CoSTR scientific reviews and statements are published continuously instead of every 5 years; however, future editions of NRP will be released every 5 years unless there is compelling evidence that mandates an earlier change.