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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 201310-0920-002 · OMB 0920-0852 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
HAI and Antimicrobial Use Point Prevalence Survey - phase 3 Form Removed Available
2011 HIA and Antimicrobial Use Point Prevalence Survey - phase 3 - training and other activities Form Removed Available
Form 1 EIP Personnel Prevalence Survey #2, Phase #3 Form Removed Available
Form 1 Infection Control Practioners Prevalence Survey #2, Phase 3 Form Removed Repair queued
Patient Information Form (PIF) Form Modified Repair queued
Healthcare Facility Assessment (HFA) Form Modified Available
Reinstatement_0920-0852_SuppStateB_v5_20130821.docx Supporting Statement B Uploaded 2013-09-25 Available
AttachmentI_FINAL_0920-0852_NonResearchDeterm.pdf Supplementary Document Uploaded 2013-09-25 Available
AttachmentH_FINAL_0920-0852_ NCHSConsultation.rtf Supplementary Document Uploaded 2013-09-25 Available
AttachmentI_ FINAL_0920-0852_InformationalDocument.pdf Supplementary Document Uploaded 2013-09-25 Available
AttachmentG_FINAL_0920-0852_SupplementalForms_20130726.docx Supplementary Document Uploaded 2013-09-25 Repair queued
AttachmentF_FINAL_0920-0852_PTInstructions_v1_20130620.pdf Supplementary Document Uploaded 2013-09-25 Available
AttachmentB_FINAL_0920-0852_60 day published.pdf Supplementary Document Uploaded 2013-09-25 Available
AttachmentC_FINAL_0920-0852_ARRA_20130618.docx Supplementary Document Uploaded 2013-09-25 Available
Attachment A 42 USC 241.pdf Supplementary Document Uploaded 2013-09-25 Repair queued
Reinstatement_0920-0852_SuppStateA_v6_20130923.doc Supporting Statement A Uploaded 2013-09-25 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
196207 HAI and Antimicrobial Use Point Prevalence Survey - phase 3 Form Removed
196206 2011 HIA and Antimicrobial Use Point Prevalence Survey - phase 3 - training and other activities Form Removed
192454 EIP Personnel Prevalence Survey #2, Phase #3 Form Removed
192453 Infection Control Practioners Prevalence Survey #2, Phase 3 Form Removed
192452 Patient Information Form (PIF) Form Modified
192451 Healthcare Facility Assessment (HFA) Form Modified
ICR Details
0920-0852 201310-0920-002
Historical Active 201102-0920-010
HHS/CDC 20565
Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 12/02/2013
Retrieve Notice of Action (NOA) 10/21/2013
  Inventory as of this Action Requested Previously Approved
12/31/2016 36 Months From Approved
21,500 0 0
6,325 0 0
0 0 0
The Centers for Disease Control and Prevention (CDC) proposes to conduct two surveys to evaluate the prevalence of healthcare-associated infections (HAIs) and antimicrobial use in acute care hospitals in multiple states. Data collection was discontinued; however, this is a request for reinstatement with minor changes.
US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 5 1 Name of Law: American Recovery and Reinvestment Act of 2009
  
None
Not associated with rulemaking
  77 FR 71798 12/04/2012
78 FR 59700 09/27/2013
No
  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 21,500 0 0 21,500 0 0
Annual Time Burden (Hours) 6,325 0 0 6,325 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a reinstatement with a reduction in burden and minor changes to data collection instruments.
$1,382,732
Yes Part B of Supporting Statement
No
No
No
Yes
Uncollected
Carol Marsh 404 639-4773 [email protected]
  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.
10/21/2013