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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:
201105-0920-001
Status:
Historical Active
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:
Approved without change
Conclusion Date:
05/12/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/02/2011
Terms of Clearance:
Approved consistent with the addition of Supporting Statement Part B.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2014
36 Months From Approved
09/30/2012
Responses
8,809,350
0
9,620,950
Time Burden (Hours)
3,914,125
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?
Yes
Number of Information Collection (IC) in this ICR:
48
IC Title
Form No.
Form Name
57.100 NHSN Registration Form
57.100
NHSN Registration Form
57.101 Facility Contact Information
57.101
Facility Contact Information
57.103 Patient Safety Component Annual Facility Survey
57.103
Patient Safety Component -- Annual Facility Survey
57.104 Patient Safety Component --Outpatient Dialysis Center Practices Survey
57.104
Patient Safety Component--Outpatient Dialysis Center Practices Survey
57.105 Group Contact Information
57.105
Group Contact Information
57.106 Patient Safety Monthly Reporting Plan
57.106
Patient Safety Monthly Reporting Plan
57.108 Primary Bloodstream Infection (BSI)
57.108
primary Bloodstream Infection (BSI)
57.109 Dialysis Event
57.109
Dialysis Event
57.111 Pneumonia (includes Any Patient Pneumonia flow Diagram and Infant and Children Pneumonia Flow Diagram)
57.111
Pneumonia (PNEU)
57.114 Urinary Tract Infection (UTI)
57.114
Urinary Tract Infection (UTI)
57.116 Denominators for Neonatal Intensive Care Unit (NICU)
57.116
Denominators for Neonatal Intensive Care Unit (NICU)
57.117 Denominators for Specialty Care Area (SCA)
57.117
Denominators for Specialty Care Area (SCA)
57.118 Denominators for Intensive Care Unit (ICU) Other Locations (not NICU or SCA)
57.118
Denominator for Intensive Care Unit (ICU)/Other locations (not NICU or SCA)
57.119 Denominators for Outpatient Dialysis
57.119
Denominators or Outpatient Dialysis
57.120 Surgical Site Infection (SSI)
57.120
Surgical Site Infection (SSI)
57.121 Denominators for Procedure
57.121
Denominator for Procedure
57.123 Antimicrobial Use and Resistance (AUR) - Microbiology Laboratory Data
57.123
Antimicrobial Use and Resistance (AUR)-Microbiology Data Electronic Upload Specification Tables
57.124 Antimicrobial Use and Resistence (AUR) - Pharmacy Data
57.124
Antimicrobial Use and Resistance (AUR)-Pharmacy Data Electronic Upload Specificaton Tables
57.125 Central Line Insertion Practices Adherence Monitoring Form
57.125
Central Line Insertion Practices (CLIP) Adherence Monitoring
57.126 MDRO Infection Event
57.126
MDRO or CDI Infection Event
57.127 MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring
57.127
MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring
57.128 Laboratory Identified MDRO Event
57.128
Laboratory-identified MDRO or CDI Event
57.130 High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method A
57.130
Vaccinatin Monthly Monitoring Form -Summary Method
57.131 High Risk Inpatient Influenza Vaccination Monthly Monitoring Form - Method B
57.131
Vaccination Monthkly Monitoring Form-Patient-Level Method
57.133 Patient Vaccination
57.133
Patient Vaccination
57.137 Patient Safety Component--Annual Facility Survey for LTCF
57.137
Patient Safety Component--Annual Facility Survey for LTCF
57.138 Laboratory-Identified MDRO or CDI Event for LTCF
57.138
Laboratory-Identified MDRO or CDI Event for LTCF
57.139 MDRO and CDI Prevention Process Measures Monthly Monitoring for LTCF
57.139
MDRO and CDI Prevention Process Measures Monthly Monitoring for LTCF
57.140 High Risk Inpatient Influenza Vaccination Denominator Data Form - Method B
57.140
Urinary Tract Infection (UTI) for LTCF
57.200 Healthcare Personnel Safety Component Facility Survey
57.200
Healthcare Personnel Safety Component Annual Facility Survey
57.202 Healthcare Worker Survey
57.202
HealthCare Worker Survey
57.203 Healthcare Personnel Safety Reporting Plan
57.203
Healthcare Personnel Safety Reporting Plan
57.204 Healthcare Worker Demographic Data
57.204
Healthcare Worker Demographic Data
57.205 Exposure to Blood and Body Fluids
57.205
Exposure to Blood/Body Fluids
57.206 Healthcare Worker Post-Exposure Prophylaxis
57.206
Healthcare Worker Prophylaxis/Treatment
57.207 Laboratory Testing
57.207
Follow-up Laboratory Testing
57.208 Healthcare Worker Vaccination History
57.208
Healthcare Worker Vaccination History
57.209 Healthcare Worker Influenza Vaccination
57.209
Healthcare Worker Influenza Vaccinatuion
57.210 Healthcare Worker Influenza Antiviral Medication Administration
57.210
Healthcare Worker Prophylaxis/Treatment Influenza
57.211 Preseason Survey on Influenza Vaccination Program for Healthcare Personnel
57.211
Pre-season Survey on Influenza Vaccination Programs for Healthcare Personnel
57.212 Post-Season Survey on Influenza Vaccination Programs for Healthcare Personnel
57.212
Post-season Survey on Influenza Vaccination Programs for Health Personnel
57.213 Healthcare Personnel Influenza Vaccination Monthly Summary
57.213
Healthcare Personnel Influenza Vaccination Monthly Summary
57.300 Hemovigilance Module Annual Survey
57.300
Hemovigilance Module Annual Survey
57.301 Hemovigilance Module Monthly Reporting Plan
57.301
Hemovigilance Module Monthly Reporting Plan
57.302 Hemovigilance Module Blood Product Incident Reporting - Summary Data
57.302
Hemovigilance Module Monthly Incident Summary
57.303 Hemovigilance Module Monthly Reporting Denominators
57.303
Hemovigilance Module Monthly Reporting Denominators
57.304 Hemovigilance Adverse Reaction
57.304
Hemovigilance Adverse Reaction
57.305 Hemovigilance Incident
57.305
Hemovigilance 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
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
8,809,350
9,620,950
0
-811,600
0
0
Annual Time Burden (Hours)
3,914,125
5,172,244
0
-1,258,119
0
0
Annual Cost Burden (Dollars)
162,000
162,000
0
0
0
0
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:
Modifications to existing forms and the deletion of several forms result in a decrease of 811,600 responses and a decrease of 1,258,119 annual burden hours.
Annual Cost to Federal Government:
$7,451,954
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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:
05/02/2011