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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:
201104-0920-012
Status:
Historical Inactive
Previous ICR Reference No:
200908-0920-002
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
The National Healthcare Safety Network (NHSN)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Improperly submitted and continue
Conclusion Date:
04/28/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/14/2011
Terms of Clearance:
This collection requires a Part B.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2012
36 Months From Approved
09/30/2012
Responses
9,620,950
0
9,620,950
Time Burden (Hours)
5,172,244
0
5,172,244
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. This revision adds a Hemovigilance module to develop a national system for outcome surveillance that included recipients of blood and blood products, and deletes two forms no longer needed by the NHSN.
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:
75 FR 62833
10/13/2010
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 12119
03/04/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
48
IC Title
Form No.
Form Name
57.100_NHSN Registration Form
CDC 57.100
NHSN Registration Form
57.101_Facility Contact Information
CDC 57.101
Facility Contact Information
57.103_Patient Safety Component Annual Facility Survey
CDC 57.103
Patient Safety Component --Annual Facility Survey
57.104_Patient Safety Component-- Outpatient Dialysis Center Practice Survey
CDC 57.104
Patient Safety Component--Outpatient Dialysis Center Practices Survey
57.105_Group Contact Information
CDC 57.105
Group Contact Information
57.106_ Patient Safety Monthly Reporting Plan
CDC 57.106
Patient Safety Monthly Reporting Plan
57.108_Primary Bloodstream Infection (BSI)
CDC 57.108
Primary Bloodstream Infection (BSI)
57.109_Dialysis Event
CDC 57.109
Dialysis Event
57.111_Pneumonia (PNEU)
CDC 57.111
Pneumonia (PNEU)
57.114_Urinary Tract Infection (UTI)
CDC 57.114
Urinary Tract Infection (UTI)
57.116_Denominators for Neonatal Intensive Care Unit (NICU)
CDC 57.116
Denominators for Neonatal Intensive Care Unit (NICU)
57.117_Denominators for Specialty Care Area (SCA)
CDC 57.117
Denominators for Specialty Care Area (SCA)
57.118_Denominators for Intensive Care Unit (ICU) Other Locations (not NICU or SCA)
CDC 57.118
Denominators for Intensive Care Unit (ICU)/Other locations (not NICU or SCA)
57.119_Denominators for Outpatient Dialysis
CDC 57.119
Denominators for Outpatient Dialysis
57.120_Surgical Site Infection (SSI)
CDC 57.120
Surgical Site Infection (SSI)
57.121_Denominators for Procedure
CDC 57.121
Denominator for Procedure
57.123_Antimicrobial Use and Resistance (AUR) - Microbiology Laboratory Data
CDC 57.123
Antimicrobial Use and Resistance (AUR): Microbiology Laboratory Data Monthly Electronic Upload Specification Tables
57.124_Antimicrobial Use and Resistence (AUR) - Pharmacy Data
CDC 57.124
Antimicrobial Use and Resistance (AUR): Pharmacy Data Monthly Electronic Upload Specification Tables
57.125_Central Line Insertion Practices Adherence Monitoring Form
CDC 57.125
Central Line Insertion Practices Adherence Monitoring
57.126_MDRO or CDI Infection Event
CDC 57.126
MDRO or CDI Infection Event
57.127_Multi-drug Resistant Organism (MDRO) Prevention Process and Outcome Measures Monthly Monitoring Form
CDC 57.127
MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring
57.128_Laboratory Identified MDRO Event
CDC 57.128
Laboratory-identified MDRO or CDI Event
57.130_Vaccination Monthly Monitoring Form - Summary Method
CDC 57.130
Vaccination Monthly Monitoring Form-- Summary Method
57.131_High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method B
CDC 57.131
Vaccination Monthly Monitoring Form-- Patient-Level Method
57.133_Patient Vaccination
CDC 57.133
Patient Vaccination
57.137_Patient Safety Component --Annual Facility Survey for LTCF
CDC 57.137
Patient Safety Component --Annual Facility Survey for LTCF
57.138 Laboratory-identified MDRO or CDI Event for LTCF
57.138
57.138_LabIDEvent_ LTCF_BLANK
57.139_MDRO or CDI Prevention Process Measures Monthly Monitoring for LTCF
CDC 57.139
MDRO and CDI Prevention Process Measures Monthly Monitoring for LTCF
57.140 Urinary Tract Infection (UTI) for LTCF
CDC 57.140
Urinary Tract Infection (UTI) for LTCF
57.200_Healthcare Personnel Safety Component Facility Survey
CDC 57.200
Healthcare Personnel Safety Component Annual Facility Survey
57.202_Healthcare Worker Survey
CDC 57.202
Healthcare Worker Survey
57.203_Healthcare Personnel Safety Reporting Plan
CDC 57.203
Healthcare Personnel Safety Monthly Reporting Plan
57.204_Healthcare Worker Demographic Data
CDC 57.204
Healthcare Worker Demographic Data
57.205_Exposure to Blood and Body Fluids
CDC 57.205
Exposure to Blood/Body Fluids
57.206_Healthcare Worker Post-Exposure Prophylaxis
CDC 57.206
Healthcare Worker Prophylaxis/Treatment
57.207_Follow-up Laboratory Testing
CDC 57.207
Follow-up Laboratory Testing
57.208_Healthcare Worker Vaccination History
CDC 57.208
Healthcare Worker Vaccination History
57.209_Healthcare Worker Influenza Vaccination
CDC Form 57.209
Healthcare Worker Influenza Vaccination
57.210_Healthcare Worker Influenza Antiviral Medication Administration
CDC 57.210
Healthcare Worker Prophylaxis/Treatment
57.211_Preseason Survey on Influenza Vaccination Program for Healthcare Personnel
CDC 57.211
Pre-season Survey on Influenza Vaccination Programs for Healthcare Personnel
57.212_Post-Season Survey on Influenza Vaccination Programs for Healthcare Personnel
CDC 57.212
Post-season Survey on Influenza Vaccination Programs for Healthcare Personnel
57.213_Healthcare Personnel Influenza Vaccination Monthly Summary
CDC 57.213
Healthcare Personnel Influenza Vaccination Monthly Summary
57.300_Hemovigilance Module Annual Survey
CDC 57.300
Hemovigilance Module Annual Facility Survey
57.301_Hemovigilance Module Monthly Reporting Plan
CDC 57.301
Hemovigilance Module Monthly Reporting Plan
57.302_Hemovigilance Module Blood Product Incident Reporting - Summary Data
CDC 57.302
Hemovigilance Module Monthly Incident Summary
57.303_Hemovigilance Module Monthly Reporting Denominators
CDC 57.303
hemovigilance Module Monthly Reporting Denominators
57.304_Hemovigilance Adverse Reaction
CDC 57.304
Hemovigilance Module Adverse Reaction
57.305_Hemovigilance Module Adverse Reaction
CDC 57.305
Hemovigilance Module Incident
Agreement to Participate and Consent
57.75T
Agreement to Participate and Consent
List of Blood Isolates
57.75CC
List of Blood Isolates
Manual Categorization of Positive Blood Cultures
57.75DD
Manual Categorization of Positive Cultures
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:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
Annual Cost to Federal Government:
$7,451,954
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]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
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:
Thelma Sims 4046394771
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:
04/14/2011
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