OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals

ICR 201304-0920-003 · OMB 0920-0852 · Historical Inactive

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0852 Primary Team/ EIP Team Data Collection Form Form and Instruction Modified Repair queued
Form 0920-0852 Infection Control Practioners training and other activities Form and Instruction Modified Available
Form 1 EIP Personnel Prevalence Survey #2, Phase #3 Form Removed Repair queued
Form 1 Infection Control Practioners Prevalence Survey #2, Phase 3 Form Removed Available
Form 1 EIP Personnel Prevalence Survey #1, Phase 2 Form Removed Available
Form 1 Infection Control Practioners Prevalence Survey #1, Phase 2 Form Removed Available
0920-0852 Supporting Statement B_FINAL_20121108_ssm.docx Supporting Statement B Uploaded 2013-04-01 Available
AttachmentE_0920-0852_ NCHSConsultation_20121108.rtf Supplementary Document Uploaded 2013-04-02 Available
Atttach G IRB.pdf Supplementary Document Uploaded 2013-04-01 Available
Attachment A 42 USC 241.pdf Supplementary Document Uploaded 2013-04-01 Repair queued
AttachmentF_0920-0852_SupplementalInformationOnly_FINAL_20121108.docx Supplementary Document Uploaded 2013-04-02 Repair queued
0920-0852 Supporting Statement A_032513.doc Supporting Statement A Uploaded 2013-04-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
196207 Primary Team/ EIP Team Data Collection Form Form and Instruction Modified
196206 Infection Control Practioners training and other activities Form and Instruction Modified
192454 EIP Personnel Prevalence Survey #2, Phase #3 Form Removed
192453 Infection Control Practioners Prevalence Survey #2, Phase 3 Form Removed
192452 EIP Personnel Prevalence Survey #1, Phase 2 Form Removed
192451 Infection Control Practioners Prevalence Survey #1, Phase 2 Form Removed
ICR Details
0920-0852 201304-0920-003
Historical Inactive 201102-0920-010
HHS/CDC 19220
Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals
Extension without change of a currently approved collection   No
Regular
Improperly submitted and continue 04/29/2013
Retrieve Notice of Action (NOA) 04/03/2013
The Program will discontinue the current ICR and submit a reinstatment with change once plans for the 2014 collection have been finalized.
  Inventory as of this Action Requested Previously Approved
05/31/2013 36 Months From Approved 05/31/2013
134,480 0 134,480
17,164 0 17,164
0 0 0
This is a request to conduct phase 3 of this approved project: CDC proposes to conduct 2 surveys to evaluate the prevalence of healthcare-associated infections (HAIs) and antimicrobial use in acute care hospitals in multiple states. This is a three-phase project. The first phase, a small, single-city pilot survey with less than 9 respondents, is complete. Phases 2 and 3 will be conducted in collaboration with state public health authorities and with CDC's Emerging Infections Program (EIP). Phase 2 will be a limited roll-out survey involving up to 30 healthcare facilities in the 10 states with EIP sites. Phase 3, built upon experience gained in the limited roll-out, will involve up to 500 facilities in the 10 states with EIP sites using the same survey. CDC does not anticipate making changes to the data collection instrument in Phase 3.
PL: Pub.L. 111 - 5 1 Name of Law: American Recovery and Reinvestment Act of 2009
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  77 FR 71798 12/04/2012
78 FR 13344 02/27/2013
Yes
No
No
The burden has been increased from 9,125 to 9,375 hours. This incrase of 250 hours is due to the actual experience of performing the phase 3 survey and knowledge of the median number of responses per respondent.
$1,455,019
Yes Part B of Supporting Statement
No
No
No
Yes
Uncollected
Catina Conner 4046394775
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/03/2013