Information Collection Request

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

ICR 200807-0935-001 · OMB 0935-0144 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
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

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2010 24 Months From Approved
2,618 0 0
1,313 0 0
0 0 0





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


Reginfo record details
  No