Reducing Healthcare Associated Infections (HAI): Improving patient safety through implementing multi-disciplinary interventions

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form #6 Training Evaluation	Form	New	Available
Form Form #5 Infection Prevention and Patient Safety Activity Catalogue	Form	New	Available
Form Form #4 Follow-up Infection Rate Summary	Form	New	Available
Form Form #3 Baseline Infection Rate Summary	Form	New	Available
Form Form #2 Post-Training Infection Prevention and Safety Assessment	Form	New	Available
Form Form #1 Pre-Training Infection Prevention and Safety Assessment	Form	New	Available
Response.to.OMB.Questions.AHRQ.11.2008.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment I -- HAI Project Overview.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment H -- Fielding Instructions.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment G -- Action Partnerships & Collaborting Hospitals.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment F -- 60 Day Federal Register Notice.pdf	Supplementary Document	Uploaded 2008-11-07	Available
Attachment E -- Summary of Common Data Collection Instruments.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment D -- Patient safety and Infection Prevention Assessment.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment C -- Patient Safety and Infection Prevention Catalogue.doc	Supplementary Document	Uploaded 2008-11-07	Available
Attachment B -- HIA Information Collection and Reporting Summary.doc	Supplementary Document	Uploaded 2008-11-07	Available
Supporting Statement Part B -- Reducing HAI 11-7-2008.doc	Supporting Statement B	Uploaded 2008-11-07	Available
Attachment A -- Healthcare Research and Quality Act of 1999.pdf	Supplementary Document	Uploaded 2008-06-20	Available
Supporting Statement Part A -- Reducing HAI 11-7-2008.doc	Supporting Statement A	Uploaded 2008-11-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
185571	Training Evaluation	Form	New	Training Evaluation
185570	Infection Prevention and Patient Safety Activity Catalogue	Form	New	Infection Prevention and Patient Safety Activity Catalogue
185569	Follow-up Infection Rate Summary	Form	New	Follow-up Infection Rate Summary
185568	Baseline Infection Rate Summary	Form	New	Baseline Infection Rate Summary
185567	Post-Training Infection Prevention and Safety Assessment	Form	New	Post-Training Infection Prevention and Safety Assessment
185566	Pre-Training Infection Prevention and Safety Assessment	Form	New	Pre-Training Infection Prevention and Safety Assessment

ICR Details

OMB Control No: 0935-0144	ICR Reference No: 200807-0935-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Reducing Healthcare Associated Infections (HAI): Improving patient safety through implementing multi-disciplinary interventions
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/10/2008
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/02/2008
Terms of Clearance: This ICR is approved consistent with AHRQ memo of 11-6-08 and the revised supporting statement and instruments. AHRQ agrees that this study is a set a case studies intended for hypothesis generation and for the identification of areas for future research. Study limitations will be disclosed whenever results from this study are published.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2010	24 Months From Approved
Responses	2,618	0	0
Time Burden (Hours)	1,313	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The goal of the HAI project is to identify factors associated with the implementation of training that can assist hospitals in successfully reducing and sustaining the reduction of infections associated with the process of care. The project is being carried out pursuant to AHRQ's statutory mandates under 42 USC 299b(b) and 299(b)(1)(G) to disseminate research findings to community settings for practice improvement and to support research on determinants of practitioner use and development of best practices. The findings from the HAI project will be shared publicly to assist other healthcare organizations in their efforts to improve infection safety.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 18284	04/03/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 32712	06/10/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Baseline Infection Rate Summary	Form #3	Baseline Infection Rate Summary
Follow-up Infection Rate Summary	Form #4	Follow-up Infection Rate Summary
Infection Prevention and Patient Safety Activity Catalogue	Form #5	Infection Prevention and Patient Safety Activity Catalogue
Post-Training Infection Prevention and Safety Assessment	Form #2	Post-Training Infection Prevention and Safety Assessment
Pre-Training Infection Prevention and Safety Assessment	Form #1	Pre-Training Infection Prevention and Safety Assessment
Training Evaluation	Form #6	Training Evaluation

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ICR Summary of Burden

table that charts list of burden

	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	2,618	0	0	2,618	0	0
Annual Time Burden (Hours)	1,313	0	0	1,313	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a request for a new information collection.

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Annual Cost to Federal Government: $145,150

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 07/02/2008

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