OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Nurse Fatigue-Mitigation Education: Does it Change Nurse Sleep Behavior?

ICR 202502-0920-007 · OMB 0920-1367 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-21FC Consensus Sleep Diary Form Unchanged Repair queued
Form 0920-21FC Immediate Post-Training Survey Form and Instruction Unchanged Repair queued
Form 0920-21FC Post-Training (1, 3, and 6-months) Survey Form and Instruction Unchanged Missing upstream
Form 0920-22FC Baseline Survey Form and Instruction Unchanged Available
CHANGE REQUEST 0920-1367_Common Form.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-02-28 Available
Wong.Privacy Act Determination.docx Supplementary Document Uploaded 2022-06-16 Missing upstream
Wong.Privacy Act Checklist_.docx Supplementary Document Uploaded 2022-06-16 Repair queued
Wong.AppendixB.OMB.2021.4.30.docx Supplementary Document Uploaded 2022-06-16 Repair queued
Attachment G.Determination.CIO-HSC.docx Supplementary Document Uploaded 2022-06-16 Available
Attachment F. Public Comments.docx Supplementary Document Uploaded 2022-06-16 Missing upstream
Attachment A.OSH Act.docx Supplementary Document Uploaded 2022-06-16 Missing upstream
Supporting Statement B.docx Supporting Statement B Uploaded 2022-06-16 Repair queued
Supporting Statement A Nurse_Fatigue.2022.8.18.docx Supporting Statement A Uploaded 2022-08-19 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
254348 Actigraphy watch training Instruction Unchanged
254320 Actigraphy watch Fitting Other-Actigraphy watch fitting Unchanged
254319 Consensus Sleep Diary Form Unchanged
254318 Immediate Post-Training Survey Form and Instruction Unchanged
254317 Post-Training (1, 3, and 6-months) Survey Form and Instruction Unchanged
254265 Online Nurses Training Other-Webpage Unchanged
254264 Baseline Survey Form and Instruction Unchanged
ICR Details
0920-1367 202502-0920-007
Received in OIRA 202206-0920-011
HHS/CDC 0920-21FC
Nurse Fatigue-Mitigation Education: Does it Change Nurse Sleep Behavior?
No material or nonsubstantive change to a currently approved collection   Yes
Regular 03/05/2025
  Requested Previously Approved
08/31/2025 08/31/2025
350 350
341 341
0 0
The purpose of this project is to evaluate the effectiveness of the NIOSH online “Training for Nurses on Shift Work and Long Work Hours”. NIOSH is committed to providing educational materials to employers and workers on workplace health and safety topics. Part of this commitment is regular evaluation of education products to determine if NIOSH-sponsored products are still successful at communicating and translating knowledge, impactful to worker health and safety. This evaluation is supported by NIOSH intramural NORA funding and will evaluate RN sleep health and wellbeing pre- and post-training. NIOSH intends to Discontinue this data collection. However, attempts to perform this action in ROCIS result in an Error Message “The OMB Control Number cannot be Discontinued because it is a Common Form.” NIOSH did not intend to have this data collection approved as a Common Form and this was done in error. This Non-Substantive Change Request is submitted to change the status of this collection and allow the subsequent submission of a Discontinuation. There is no change in burden.
None
None
Not associated with rulemaking
  86 FR 26517 05/14/2021
87 FR 35780 06/13/2022
Yes
  Total Request 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 350 350 0 0 0 0
Annual Time Burden (Hours) 341 341 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The purpose of this project is to evaluate the effectiveness of the NIOSH online “Training for Nurses on Shift Work and Long Work Hours”. NIOSH estimates a total annual response burden of 341 hours for this new information collection.
$276,000
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [email protected]
  Yes
  NIOSH intends to Discontinue this data collection. However, attempts to perform this action in ROCIS result in an Error Message “The OMB Control Number cannot be Discontinued because it is a Common Form.” NIOSH did not intend to have this data collection approved as a Common Form and this was done in error. This Non-Substantive Change Request is submitted to change the status of this collection and allow the subsequent submission of a Discontinuation. There is no change in burden.
Agency/Sub Agency RCF ID RCF Title RCF Status IC Title
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.
03/05/2025