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 201612-0920-005 · OMB 0920-0852 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form Phase 4_PIF_201412 Att E_Patient Information Form (PIF) Form Unchanged Repair queued
Form Phase 4_HFA_201411 Att D_Healthcare Facility Assessment (HFA) Form Unchanged Repair queued
Non-sub change request 0920-0852.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-12-08 Repair queued
Att. N - Multistate Point-Prevalence Survey of Health Care–Associated Infections.pdf Supplementary Document Uploaded 2016-12-08 Available
Att. M - Methodology for estimating national prevalance for OMB 0920-0852.docx Supplementary Document Uploaded 2016-12-08 Available
Att L - Non-research determination.pdf Supplementary Document Uploaded 2016-09-19 Available
SSB 0920-0852 Revision.docx Supporting Statement B Uploaded 2016-09-19 Repair queued
Att H - NCHS Consultation.rtf Supplementary Document Uploaded 2016-09-19 Repair queued
Att I - Informational Document.pdf Supplementary Document Uploaded 2016-09-19 Available
Att B - 60 Day FRN.pdf Supplementary Document Uploaded 2016-09-19 Repair queued
Att C - ARRA.docx Supplementary Document Uploaded 2016-09-19 Available
Attachment A 42 USC 241.pdf Supplementary Document Uploaded 2013-09-25 Repair queued
SSA 0920-0852 Revision.doc Supporting Statement A Uploaded 2016-09-19 Available
IC Document Collections
IC IDCollectionTypeStatusForm
192452 Att E_Patient Information Form (PIF) Form Unchanged
192451 Att D_Healthcare Facility Assessment (HFA) Form Unchanged
ICR Details
0920-0852 201612-0920-005
Historical Active 201608-0920-019
HHS/CDC 0920-0852
Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/12/2016
Retrieve Notice of Action (NOA) 12/08/2016
  Inventory as of this Action Requested Previously Approved
12/31/2019 12/31/2019 12/31/2019
6,400 0 6,400
1,860 0 1,860
0 0 0
The goal of this survey is to determine the prevalence of HAIs in hospital patients, types of HAIs and causative pathogens, nature and extent of antimicrobial use in hospitals, prevalence of inappropriate antimicrobial use and opportunities for improvement in antimicrobial use in hospitals, and prevalence of antimicrobial resistance among pathogens causing HAIs.
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
  81 FR 45164 07/12/2016
81 FR 66965 09/29/2016
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 6,400 6,400 0 0 0 0
Annual Time Burden (Hours) 1,860 1,860 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The burden reduction of 1890 hours is because it is expected that a survey will only happen once in the coming three years. The previous approval included the completion of two surveys in a three year period. In addition, the number of hospitals is being reduced from 500 to 300.
$1,549,916
Yes Part B of Supporting Statement
No
No
No
Yes
Uncollected
Thelma Sims 4046394771
  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.
12/08/2016