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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0666
ICR Reference No:
200906-0920-001
Status:
Historical Inactive
Previous ICR Reference No:
200901-0920-009
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
The National Healthcare Safety Network (NHSN)
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Improperly submitted and continue
Conclusion Date:
06/12/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/08/2009
Terms of Clearance:
This submission requests the addition of data elements and should be resubmitted as a "substantive" change.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2011
03/31/2011
03/31/2011
Responses
9,511,550
0
9,511,550
Time Burden (Hours)
5,144,844
0
5,144,844
Cost Burden (Dollars)
162,000
0
162,000
Abstract:
The NHSN is a knowledge system for accumulating, exchanging and integrating relevant information and resources among private and public stakeholders to support local and national efforts to protect patients and healthcare personnel by promoting healthcare safety. Specifically, the data will be used to determine the magnitude of various healthcare-associated adverse events and trends in the rates of these events among patients and healthcare personnel with similar risks or exposures.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
72 FR 41077
07/26/2007
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 65578
11/21/2007
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
49
IC Title
Form No.
Form Name
Agreement to Participate and Consent
57.75T
Agreement to Participate and Consent
Antimicrobial Use and Resistance (AUR) - Microbiology Laboratory Data
57.75P
Antimicrobial Use and Resistance (AUR) - Microbiology Laboratory Data
Antimicrobial Use and Resistence (AUR) - Pharmacy Data
57.75Q
Antimicrobia Use and Resistence (AUR) - Pharmacy Data
Central Line Insertion Practices Adherence Monitoring Form
57.75JJ
Central Line Insertion Practices Adherence Monitoring Form
Denominators for Intensive Care Unit (ICU) Other Locations (not NICU or SCA)
57.75L
Denominators for Intensive Care Unit (ICU) Other Locations (not NICU or SCA)
Denominators for Neonatal Intensive Care Unit (NICU)
57.75J
Demonination for Neonatal Intensive Care Unit (NICU)
Denominators for Outpatient Dialysis
57.75M
Denominators for Outpatient Dialysis
Denominators for Procedure
57.75O
Denominators for Procedure
Denominators for Specialty Care Area (SCA)
57.75K
Denominators for Specialty Care Area (SCA)
Dialysis Event
57.75E
Dialysis Event
Dialysis Survey
57.75BB
Dialysis Survey
Exposure to Blood and Body Fluids
57.75V
Exposure to Blood and Body Fluids
Facility Contact Information
57.75R
Facility Contact Information
Group Contact Information
57.75U
Group Contact Information
Healthcare Personnel Safety Component Facility Survey
57.75Za
Healthcare Personnel Safety Component Facility Survey
Healthcare Personnel Safety Reporting Plan
57.75B
Healthcare Personnel Safety Reporting Plan
Healthcare Worker Demographic Data
57.75X
Healthcare Worker Demographic Data
Healthcare Worker Influenza Antiviral Medication Administration
57.75GG
Healthcare Worker Influenza Antiviral Medication Administration
Healthcare Worker Influenza Vaccination
57.75FF
Healthcare Worker Influenza Vaccination
Healthcare Worker Post-Exposure Prophylaxis
57.75W
Healthcare Worker Post-Exposure Prophylaxis
Healthcare Worker Survey
57.75AA
Healthcare Worker Survey
Healthcare Worker Vaccination History
57.75Y
Healthcare Worker Vaccination History
Hemovigilance Module - Adverse reaction report
No number
Adverse reaction report
Hemovigilance Module - Annual Facility Survey
No number
Annual facility survey
Hemovigilance Module - Blood product incident reporting summary data
No number
Blood product incident reporting summary data
Hemovigilance Module - Incident report
No number
Incident report
Hemovigilance Module - Monthly reporting denominators
No number
Monthly reporting denominators
Hemovigilance Module - Monthly reporting plan
No number
Monthly reporting plan
High Risk Inpatient Influenza Vaccination Denominator Data Form - Method B
57.75SS
High Risk Inpatient Influenza Vaccination Denominator Data Form - Method B
High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method A
57.75PP
High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method A
High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method B
57.75RR
High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method B
High Risk Inpatient Influenza Vaccination Numerator Data Form - Method B
57.75QQ
High Risk Inpatient Influenza Vaccination Numerator Data Form - Method B
Implementation of Engineering (safety devices) Controls for Sharps Injury Prevention
57.75Z
Implementation of Engineering (safety devices) Controls for Sharps Injury Prevention
Laboratory Identified MDRO Event
57.75NN
Laboratory Identified MDRO Event
Laboratory Testing
57.75KK
Laboratory Testing
Laboratory-identified MDRO Event Summary Form
57.75TT
Laboratory-identified MDRO Event Summary Form
List of Blood Isolates
57.75CC
List of Blood Isolates
MDRO Infection Event
57.75MM
MDRO Infection Event
Manual Categorization of Positive Blood Cultures
57.75DD
Manual Categorization of Positive Cultures
Multi-drug Resistant Organism (MDRO) Prevention Process and Outcome Measures Monthly Monitoring Form
57.75LL
Multi-drug Resistant Organism (MDRO) Prevention Process and Outcome Measures Monthly Monitoring Form
NHSN Registration Form
57.75OO
NHSN Registration Form
Patient Safety Component Annual Facility Survey
57.75S
Patient Safety Component Annual Facility Survey
Patient Safety Monthly Reporting Plan
57.75A
A_PSPlan.ppt
Pneumonia (includes Any Patient Pneumonia flow Diagram and Infant and Children Pneumonia Flow Diagram)
57.75G, 57.75Ga, 57.75Gb
Pneumonia (includes Any Patient Pneumonia Flow Diagram and Infant and Children Pneumonia Flow Diagram)
Post-Season Survey on Influenza Vaccination Programs for Healthcare Personnel
57.75II
Post-Season Survey on Influenza Vaccination Programs for Healthcare Personnel
Preseason Survey on Influenza Vaccination Program for Healthcare Personnel
57.75HH
Preseason Survey on Influenza Vaccination Programs for Healthcare Personnel
Primary Bloodstream Infection (BSI)
57.75D
Primary Bloodstream Infection (BSI)
Surgical Site Infection (SSI)
57.75N
Surgical Site Infection (SSI)
Urinary Tract Infection (UTI)
57.75H
Urinary Tract Infection (UTI)
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
In response to a recommendation from an HHS Advisory Committee on Blood Safety and Availability, CDC requests approval to add a Hemovigilance module. There is no change to respondents, and an increase of 32,200 burden hours to the previously approved 5,140,345 hours.
Annual Cost to Federal Government:
$2,093,612
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Maryam Daneshvar 4046394604
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
06/08/2009
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