Information Collection Request

Spreading Techniques to Radically Reduce Antibiotic Resistant Bacteria (Methicillin Resistant Staphylococcus aureus, or MRSA)

ICR 201007-0935-001 · OMB 0935-0168 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #6 Patient Healthcare Use Questionnaire Form and Instruction New Available
Form Form #5 Implementation Assessment Interviews Form and Instruction New Available
Form Form #4 Culture Questionnaire Form and Instruction New Available
Form Form #3 Social Network Analysis Questionnaire Form and Instruction New Available
Form Form #2 Observational Data Collection Form and Instruction New Available
Attachment G -- Patient Health Care Use Questionnaire.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment D -- Social Network Analysis Questionnaire.doc Supplementary Document Uploaded 2010-09-20 Available
Supporting Statement Part B -- Spreading Techniques to Radically Reduce MRSA 9-15-2010.docx Supporting Statement B Uploaded 2010-09-20 Available
Attachment H -- 30 Day FRN.pdf Supplementary Document Uploaded 2010-06-14 Available
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document Uploaded 2010-06-10 Available
Supporting Statement Part A -- Spreading Techniques to Radically Reduce MRSA 9-15-2010-1.doc Supporting Statement A Uploaded 2010-09-20 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
193538 Patient Healthcare Use Questionnaire Form and Instruction New
193537 Implementation Assessment Interviews Form and Instruction New
193536 Culture Questionnaire Form and Instruction New
193535 Social Network Analysis Questionnaire Form and Instruction New
193534 Observational Data Collection Form and Instruction New
193533 Electronic Medical Record Data Collection Other-List of variables extracted New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2012 24 Months From Approved
5,324 0 0
2,458 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 5,324 0 0 5,324 0 0
Annual Time Burden (Hours) 2,458 0 0 2,458 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No