Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
HAI and Antimicrobial Use Point Prevalence Survey - phase 3	Form	New	Available
2011 HIA and Antimicrobial Use Point Prevalence Survey - phase 3 - training and other activities	Form	New	Available
Form 1 EIP Personnel Prevalence Survey #2, Phase #3	Form	Modified	Available
Form 1 Infection Control Practioners Prevalence Survey #2, Phase 3	Form	Modified	Available
Form 1 EIP Personnel Prevalence Survey #1, Phase 2	Form	Modified	Available
Form 1 Infection Control Practioners Prevalence Survey #1, Phase 2	Form	Modified	Available
0920-0852 Suppt StatementPartB.docx	Supporting Statement B	Uploaded 2011-01-31	Available
AttachmentE_0920-0852_SupplementalInformationOnly.docx	Supplementary Document	Uploaded 2011-01-31	Available
Prevalence Survey Legislation.pdf	Supplementary Document	Uploaded 2011-01-31	Available
AttachmentD_0920-0852_ NCHSConsultation.rtf	Supplementary Document	Uploaded 2011-01-31	Available
Attachment A 42 USC 241.pdf	Supplementary Document	Uploaded 2011-01-31	Available
AttachmentC_0920-0852_ARRA.docx	Supplementary Document	Uploaded 2011-01-31	Available
Justification Nonsubstantive Change.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2011-01-31	Available
SupportingStatement_0920-0852_v3_20110127.final.doc	Supporting Statement A	Uploaded 2011-01-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
196207	HAI and Antimicrobial Use Point Prevalence Survey - phase 3	Form	New
196206	2011 HIA and Antimicrobial Use Point Prevalence Survey - phase 3 - training and other activities	Form	New
192454	EIP Personnel Prevalence Survey #2, Phase #3	Form	Modified
192453	Infection Control Practioners Prevalence Survey #2, Phase 3	Form	Modified
192452	EIP Personnel Prevalence Survey #1, Phase 2	Form	Modified
192451	Infection Control Practioners Prevalence Survey #1, Phase 2	Form	Modified

ICR Details

OMB Control No: 0920-0852	ICR Reference No: 201102-0920-010
Status: Historical Active	Previous ICR Reference No: 201004-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/10/2011
	Date Received in OIRA: 02/15/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2013	05/31/2013	05/31/2013
Responses	134,480	0	61,480
Time Burden (Hours)	17,164	0	8,039
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request to conduct phase 3 of this approved project: CDC proposes to conduct 2 surveys to evaluate the prevalence of healthcare-associated infections (HAIs) and antimicrobial use in acute care hospitals in multiple states. This is a three-phase project. The first phase, a small, single-city pilot survey with less than 9 respondents, is complete. Phases 2 and 3 will be conducted in collaboration with state public health authorities and with CDC's Emerging Infections Program (EIP). Phase 2 will be a limited roll-out survey involving up to 30 healthcare facilities in the 10 states with EIP sites. Phase 3, built upon experience gained in the limited roll-out, will involve up to 500 facilities in the 10 states with EIP sites using the same survey. CDC does not anticipate making changes to the data collection instrument in Phase 3.

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Authorizing Statute(s): 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
  

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

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
2011 HIA and Antimicrobial Use Point Prevalence Survey - phase 3 - training and other activities	none	2011 HAI and Antimicrobial Use Point Prevalence Survey
HAI and Antimicrobial Use Point Prevalence Survey - phase 3	none	HAI and Antimicrobial Use Point Prevalence Survey
Infection Control Practioners Prevalence Survey #2, Phase 3	1	2010 HAI & Antimicrobial Use Point Prevalence Survey: Primary Team Data Collection Form
Infection Control Practioners Prevalence Survey #1, Phase 2	1	2010 HAI & Antimicrobial Use Point Prevalence Survey: Primary Team Data Collection Form
EIP Personnel Prevalence Survey #1, Phase 2	1	2010 HAI & Antimicrobial Use Point Prevalence Survey: Primary Team Data Collection Form
EIP Personnel Prevalence Survey #2, Phase #3	1	2010 HAI & Antimicrobial Use Point Prevalence Survey: Primary Team Data Collection Form

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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	134,480	61,480	0	73,000	0	0
Annual Time Burden (Hours)	17,164	8,039	0	9,125	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 to conduct phase 3 of the approved survey, as per the terms of clearance. The burden is associated with phase 3.

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Annual Cost to Federal Government: $111,384

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? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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

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: 02/15/2011

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