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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:
201112-0920-004
Status:
Historical Active
Previous ICR Reference No:
201105-0920-001
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:
01/16/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/08/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2015
36 Months From Approved
05/31/2014
Responses
9,672,750
0
8,809,350
Time Burden (Hours)
3,978,175
0
3,914,125
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 request includes six new forms and small revisions to 20 previously approved forms. The reporting burden will increase by 64,050 hours, for a total estimated burden of 3, 978,175 hours; annual cost of reporting would increase by $4,781,769.
Authorizing Statute(s):
US Code:
42 USC 242b
Name of Law: Public Health Service Act
US Code:
42 USC 242m
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
US Code: 42 USC 242k Name of Law: Public Health Service Ac t
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:
76 FR 177
09/13/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 74066
11/30/2011
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
54
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
57.104 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)
57.109 Dialysis Event
57.111 Pneumonia (includes Any Patient Pneumonia flow Diagram and Infant and Children Pneumonia Flow Diagram)
57.111
Pneumonia (PNEU)
57.112 Streamlined Ventilator-Associated Pneumonia
57.114 Urinary Tract Infection (UTI)
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
57.120 Surgical Site Infection (SSI)
57.121 Denominators 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
57.126 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 or CDI MDRO Event
57.130 Vaccination Monthly Monitoring Form - Summary Method
57.131 Vaccination Monthly Monitoring Form - Patient-Level Method
57.133 Patient Vaccination
57.137 Long Term care Facility Component--Annual Facility Survey
57.138 Laboratory-Identified MDRO or CDI Event for LTCF
57.139 MDRO and CDI Monthly Monitoring for LTCF
57.140 Urinary Tract Infection (UTI) for LTCF
57.141 Monthly Reporting Plan for LTCF
57.142 Denominators for LTCF Locations
57.143 Prevention Process Measures Monthly Monitoring for LTCF
57.150 Patient Safety Component -- Annual Facility Survey for LTAC
57.151 Patient Safety Component -- Annual Facility Survey for IRF
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 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 Prophylaxis/Treatment - Influenza
57.210
Healthcare Worker Prophylaxis/Treatment Influenza
57.211 Preseason Survey on Influenza Vaccination Program 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 Facility Survey
57.301 Hemovigilance Module Monthly Reporting Plan
57.301
Hemovigilance Module Monthly Reporting Plan
57.302 Hemovigilance Module Monthly Incident Summary
57.303 Hemovigilance Module Monthly Reporting Denominators
57.303
Hemovigilance Module Monthly Reporting Denominators
57.304 Hemovigilance Module Adverse Reaction
57.305 Hemovigilance Module Incident
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
9,672,750
8,809,350
1,363,400
0
-500,000
0
Annual Time Burden (Hours)
3,978,175
3,914,125
106,242
0
-42,192
0
Annual Cost Burden (Dollars)
162,000
162,000
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Twenty data collection tools previously approved under OMB No. 0920-0666 have been revised in this revision request. In addition, six new forms are being submitted for approval.
Annual Cost to Federal Government:
$8,673,111
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:
12/08/2011