View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
202505-0920-007
Status:
Historical Inactive
Previous ICR Reference No:
202502-0920-016
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-25-0119
Title:
[NCEZID] 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:
Emergency
Approval Requested By:
12/31/2024
OIRA Conclusion Action:
Withdrawn
Conclusion Date:
06/27/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/20/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2025
06/30/2025
Responses
0
0
5,896,361
Time Burden (Hours)
0
0
4,508,255
Cost Burden (Dollars)
0
0
0
Abstract:
The National Healthcare Safety Network (NHSN) is a system designed to accumulate, exchange, and integrate relevant information and resources among private and public stakeholders to support local and national efforts to protect patients and promote healthcare safety. Specifically, the data is used to determine the magnitude of various healthcare-associated adverse events and trends in the rates of these events among patients and healthcare workers with similar risks. The data will be used to detect changes in the epidemiology of adverse events resulting from new and current medical therapies and changing risks. This is a change request that makes revisions to one form with no change to the burden. This change is not related to any E.O. or SPD-15.
Emergency Justfication:
Emergency Processing is requested to add three (3) additional pathogens of concern to the NHSN (OMB Control No. 0920-0666) data collection: Influenza A (H5), Marburg, and Oropouche. This requested update in disease surveillance will illustrate which patient populations are being affected by these pathogens and the potential need for additional healthcare infection prevention and control. Since this form is collecting data on hospitalized patients, the update will also help inform on the severity of illness a high consequence pathogen is causing as well as what region(s) of the country are affected. Data collection is vital to ensure that local and state authorities are supported to prepare for and respond to emerging outbreaks.
Authorizing Statute(s):
US Code:
42 USC 242k
Name of Law: Public Health Service Act
US Code:
42 USC 242m(d)
Name of Law: Public Health Service Act
US Code:
42 USC 242b
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
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
98
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 Hospital Survey
57.103
Patient Safety Component-Annual Hospital Survey
57.104 NHSN Administrator Change Request Form
none
Facility Administrator Change Request
57.105 Group Contact Information
CDC 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)
57.111 Pneumonia (includes Any Patient Pneumonia flow Diagram and Infant and Children Pneumonia Flow Diagram)
57.111
Pneumonia (PNEU)
57.112 Ventilator-Associated Event (VAE)
57.112
Ventilator Associated Event (VAE)
57.113 Pediatric Ventilator-Associated Event (PedVAE)
57.113
Pediatric Ventilator-Associated Event (PedVAE)
57.114 Urinary Tract Infection (UTI)
57.114
Urinary Tract infection (UTI)
57.115 Custom Event
CDC 57.115
Custom Event
57.116 Denominators for Neonatal Intensive Care Unit (NICU)
CDC 57.116
PedVAE Optional Denominators Neonatal Intensive Care Unit (NICU)
57.117 Denominators for Specialty Care Area (SCA)/Onocology (ONC)
CDC 57.117
Denominators for Specialty Care Area (SCA)/Oncology (ONC)
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)
57.120 Surgical Site Infection (SSI)
CDC 57.120
Surgical Site Infection
57.121 Denominators for Procedure
57.121
Denominator for Procedure
57.122 HAI Progress Report State Health Department Survey
CDC 55.122
State Health Department HAI Mandate and Validatyion Survey
57.123 Antimicrobial Use and Resistance (AUR) - Microbiology Data Upload Tables
57.123
Antimicrobial Use and Resistance (AUR): Microbiology Laboratory Data Monthly Electronic Upload Specification Tables
57.124 Antimicrobial Use and Resistence (AUR) - Pharmacy Data
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 MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring
CDC 57.127
MDRO and CDI Prevention Process and Outcome Measures Monthly Reporting
57.128 Laboratory Identified or CDI MDRO Event
57.128
Laboratory-identified MDRO or CDI Event
57.129_Adult Sepsis
57.129
Adult Sepsis_
57.130 Pathogens of High Consequence
0920-0666, 57.130
Pathogens of High Consequence
,
57.130 - Pathogens of High Consequesce [23DEC2024]
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-IT Initial Set up
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-IT Yearly Maintenance
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-Infection Preventionist
57.132
Reporting Plan HOB and HTCDI
57.132 - Patient Safety Digital Reporting Plan (RPS CSV)
57.132
Patient Safety Digital Reporting Plan (RPS CSV)
57.137 Long Term care Facility Component--Annual Facility Survey
CDC 57.137
Long-Term Care Facility Component -- Annual Facility Survey
57.138 Laboratory-Identified MDRO or CDI Event for LTCF
CDC 57.138
Laboratory-identified MDRO or CDI Event for LTCF
57.139 MDRO and CDI Prevention Process Measures Monthly for LTCF
CDC 57.139
MDRO and CDI LabID Event Reporting Monthly Summary Data for LTCF
57.140 Urinary Tract Infection (UTI) for LTCF
57.140
Urinary Tract Infection (UTI) for LTCF
57.141 Monthly Reporting Plan for LTCF
CDC 57.141
Monthly Reporting Plan for LTCF
57.142 Denominators for LTCF Locations
CDC 57.142
Denominators for LTCF
57.143 Prevention Process Measures Monthly Monitoring for LTCF
CDC 57.143
Prevention Process Measures Monthly Monitoring
57.145 - Long Term Care Antimicrobial Use (LTC-AU) Module CDA
57.145
LTC-AU Module
57.150 Patient Safety Component -- Annual Facility Survey for LTAC
57.150
Urinary Tract Infection (UTI) for LTCF
57.151 Patient Safety Component -- Annual Facility Survey for IRF
57.151
Patient Safety Component—Annual Facility Survey for IRF
57.300 Hemovigilance Module Annual Survey -- Acute Care Facility
CDC 57.300
Hemovigilance Module - Annual Survey
57.301 Hemovigilance Module Monthly Reporting Plan
57.301
Hemovigilance Module Monthly Reporting Plan
57.303 Hemovigilance Module Monthly Reporting Denominators
CDC 57.303
Hemovigilance Module Monthly Reporting Denominators
57.305 Hemovigilance Incident
CDC 57.305
Hemovigilance Module Incident
57.306 Hemovigilance Module Annual Facility Survey - Non-acute Care Facility
57.306
Hemovigilance Module Annual Survey - Non-acute Care Facility
57.307 Hemovigilance Adverse Reaction - Acute Hemolytic Transfusion Reaction
57.307
Hemovigilance Adverse Reaction - Acute Hemolytic Transfusion Reaction
57.308 Hemovigilance Adverse Reaction - Allergic Transfusion Reaction
57.308
Hemovigilance Adverse Reaction - Allergic Transfusion Reaction
57.309 Hemovigilance Adverse Reaction - Delayed Hemolytic Transfusion Reaction
CDC 57.309
Hemovigilance Adverse Reaction - Delayed Hemolytic Transfusion Reaction
57.310 Hemovigilance Adverse Reaction - Delayed Serologic Transfusion Reaction
57.310
Hemovigilance Adverse Reaction - Delayed Serologic Transfusion Reaction
57.311 Hemovigilance Adverse Reaction - Febrile Non-hemolytic Transfusion Reaction
CDC 57.311
Hemovigilance Adverse Reaction - Febrile Non-hemolytic Transfusion Reaction
57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction
57.312
Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction
57.313 Hemovigilance Adverse Reaction - Infection
57.313
Hemovigilance Adverse Reaction - Infection
57.314 Hemovigilance Adverse Reaction - Post Transfusion Purpura
57.314
Hwemovilgilance Adverse Reaction - Post Transfusion Purpura
57.315 Hemovigilance Adverse Reaction - Transfusion Associated Dyspnea
CDC 57.315
Hemovigilance Adverse Reaction - Transfusion Associated Dyspnea
57.316 Hemovigilance Adverse Reaction - Transfusion Associated Graft vs. Host Disease
CDC 57.316
Hemovigilance Adverse Reaction - Transfusin Associated Graft vs. Host Disease
57.317 Hemovigilance Adverse Reaction - Transfusion Associated Acute Lung Injury
57.317
Hemovigilance Adverse Reaction - Transfusion Related Acute Lung Injury
57.318 Hemovigilance Adverse Reaction - Transfusion Associated Circulatory Overload
CDC 57.318
Hemovigilance Adverse Reaction - Transfusion Associated Circulatory Overload
57.319 Hemovigilance Adverse Reaction - Unknown Transfusion Reaction
CDC 57.319
Hemovigilance Adverse Reaction - Unknown Transfusion Reaction
57.320 Hemovigilance Adverse Reaction - Other Transfusion Reaction
57.320
Hemovigilance Adverse Reaction - Other Transfusion Reaction
57.400 Outpatient Procedure - Annual Facility Survey
CDC 57.400
Outpatient Procedure Component - Annual Facility Survey
57.401 Outpatient Procedure - Monthly Reporting Plan
CDC 57.401
Outpatient Procedure Component - Monthly Reporting Plan
57.402 Outpatient Procedure Component Event
CDC 57.402
Outpatient Procedure - Component Event
57.403 Outpatient Procedure Component - Monthly Denominators and Summary
CDC 57.403
Outpatient Procedure - Monthly Denominators and Summary
57.404 Outpatient Procedure Component - SSI Denominators
57.404
Outpatient Procedure Component - SSI Denominators
57.405 Outpatient Procedure Component - Surgical Site Infection (SSI) Event
CDC 57.405
Outpatient Procedure Component - SSI Denominators
57.500 Outpatient Dialysis Center Practices Survey
57.500
Home Dialysis Center Practices Survey
57.501 Dialysis Monthly Reporting Plan
CDC 57.501
NHSN Registration Form
57.502 Dialysis Event
CDC 57.502
Dialysis Event
57.503 Denominators for Outpatient Dialysis
CDC 57.503
Demominators for Dialysis Event Surveillance
57.504 Prevention Process Measures Monthly Monitoring for Dialysis
CDC 57.504
Prevention Process Measures Monthly Monitoring for Dialysis
57.507 Home Dialysis Center Practices Survey
57.507
Home Dialysis Center Practices Survey
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-IT Initial Set up
57.600
Reporting Plan LOSMEN Initial Set-up
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-IT Yearly Maintenance
57.600
Reporting Plan LOSMEN Yearly Maintenance
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-Infection Preventionist
57.600
Reporting Plan LOSMEN
57.600 - Neonatal Component Late Onset Sepsis Meningitis (LOSMEN) Module CDA Data Collection-Infection Preventionist
57.600
Reporting Plan LOSMEN
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-IT Initial Set up
57.700
Medication Safety-Digital Measure Reporting Plan (HYPO, HAKI, ORAE) -IT Initial Set up
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-IT Yearly Maintenance
57.700
Medication Safety-Digital Measure Reporting Plan (HYPO, HAKI, ORAE) -IT Yearly Maintenance
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-Infection Preventionist
57.700
Reporting Plan Glycemic Control Module Hypoglycemia
57.701 - Glycemic Control Module-HYPO Annual Survey
57.701
Glycemic Control Module-HYPO Annual Survey
AUR Microbiolgy Data Electronic Upload Specification Tables (Yearly Maintenance)
57.123
Yearly Maintenance (form not used)
AUR Microbiology Data Electronic Upload Specification Tables (Initial Set-up)
57.123
Initial Set-up (form not used)
AUR Pharmacy Data Electronic Upload Specification Tables (Initial Set-up)
57.124
Initial Set-up (form not used)
AUR Pharmacy Data Electronic Upload Specification Tables (Yearly Maintenance)
57.124
Yearly Maintenance (form not used)
All Hazards
57.803, 0920-25-0119
All Hazards
,
57.803 Daily Facility Operating Status
Annual Healthcare Personnel Influenza Vaccination Summary (CSV)
57.214
CSV Submission
Annual Healthcare Personnel Influenza Vaccination Summary (manual)
CDC 57.214
Annual Healthcare Personnel Influenza Vaccination Summary
Bed Capacity-IT Initial Set Up
57.802
Bed Capacity-IT Initial Set Up
Billing Code Data: 837I Upload
57.800
Billing Code Data
External Validation Summary Report
57.801
External Validation Summary Report
Hemovigilance Module Monthly Incident Summary
CDC 57.302
Hemovigilance Module Monthly Incident Summary
Late Onset Sepsis/Meningitis Denominator Form: Data Table (Monthly)
57.601
Late Onset Sepsis/ Meningitis Denominator Form: Data Table for monthly electronic upload
Long Term Care Facility Component - Respiratory Tract Infection
57.602
Long-Term Care Facility Component – Respiratory Tract Infection
Monthly Survey Patient Days & Nurse Staffing
57.408
Monthly Survey Patient Days & Nurse Staffing
NHSN Help Desk Customer Satisfaction Survey
57.102
NHSN Help Desk Customer Satisfaction Survey
Patient Safety Attestation
57.133
Patient Safety Attestation
Seasonal Survey on Influenza Vaccination Programs for Healthcare Personnel
57.215
Seasonal Survey on Influenza Vaccination Programs for Healthcare Personnel
Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities
CDC 57.211
Weekly HCP Influenza Vaccination Cumulative Summary Non-Long-Term Care Facilities
Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities (CSV)
57.211
CSV Submission
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:
Annual Cost to Federal Government:
$49,994,530
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
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?
Yes
Agency Contact:
Odion Clunis 770 488-0045 lta2@cdc.gov
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:
05/20/2025
An official website of the United States government
The .gov means it's official.
The site is secure.
