Att D.4 - Revision of Burden Cost

National Healthcare Safety Network (NHSN)

OMB Control No. 0920-0666

Revision Request February 2011

Revision of Estimated Annual Cost Burden

		Total Estimated Burden (Hours)		Estimated Hourly Wage of Respondent		Total Estimated Annual Cost Burden		Change in Estimated Annual Cost Burden
Form Number	Form Name	2009	2010	2009	2010	2009	2010
57.100	NHSN Registration Form	500	500	$34.65	$37.49	$17,325	$18,745	$1,420
57.101	Facility Contact Information	1,000	1,000	$34.65	$37.49	$34,650	$37,490	$2,840
57.102	N/A-Remove from ICR	1,500	0	$34.65	$37.49	$51,975	$0	($51,975)
57.103	Patient Safety Component--Annual Facility Survey	3,000	4,000	$34.65	$37.49	$103,950	$149,960	$46,010
57.104	Patient Safety Component--Outpatient Dialysis Center Practices Survey	225	5,500	$34.65	$37.49	$7,796	$206,195	$198,399
57.105	Group Contact Information	500	500	$34.65	$37.49	$17,325	$18,745	$1,420
57.106	Patient Safety Monthly Reporting Plan	31,500	31,500	$34.65	$37.49	$1,091,475	$1,180,935	$89,460
57.108	Primary Bloodstream Infection (BSI)	108,000	115,200	$34.65	$37.49	$3,742,200	$4,318,848	$576,648
57.109	Dialysis Event	11,250	9,375	$29.58	$30.65	$332,775	$287,344	($45,431)
57.111	Pneumonia (PNEU)	216,000	230,400	$34.65	$37.49	$7,484,400	$8,637,696	$1,153,296
57.112	N/A-Remove from ICR	-	-	-	-	-	-	-
57.113	N/A-Remove from ICR	-	-	-	-	-	-	-
57.114	Urinary Tract Infection (UTI)	81,000	86,400	$34.65	$37.49	$2,806,650	$3,239,136	$432,486
57.116	Denominators for Neonatal Intensive Care Unit (NICU)	216,000	216,000	$29.58	$30.65	$6,389,280	$6,620,400	$231,120
57.117	Denominators for Specialty Care Area (SCA)	270,000	270,000	$29.58	$30.65	$7,986,600	$8,275,500	$288,900
57.118	Denominators for Intensive Care Unit (ICU)/Other locations (not NICU or SCA)	540,000	540,000	$29.58	$30.65	$15,973,200	$16,551,000	$577,800
57.119	Denominator for Outpatient Dialysis	169	500	$29.58	$30.65	$4,992	$15,325	$10,333
57.120	Surgical Site Infection (SSI)	81,000	86,400	$34.65	$37.49	$2,806,650	$3,239,136	$432,486
57.121	Denominator for Procedure	432,000	540,000	$29.58	$30.65	$12,778,560	$16,551,000	$3,772,440
57.123	Antimicrobial Use and Resistance (AUR)-Microbiology Data Electronic Upload Specification Tables	810,000	6,000	$17.25	$17.32	$13,972,500	$103,920	($13,868,580)
57.124	Antimicrobial Use and Resistance (AUR)-Pharmacy Data Electronic Upload Specification Tables	432,000	6,000	$13.18	$13.49	$5,693,760	$80,940	($5,612,820)
57.125	Central Line Insertion Practices Adherence Monitoring	100,000	50,000	$34.65	$37.49	$3,465,000	$1,874,500	($1,590,500)
57.126	MDRO or CDI Infection Form	216,000	230,400	$34.65	$37.49	$7,484,400	$8,637,696	$1,153,296
57.127	MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring	24,000	24,000	$34.65	$37.49	$831,600	$899,760	$68,160
57.128	Laboratory-identified MDRO or CDI Event	720,000	600,000	$34.65	$37.49	$24,948,000	$22,494,000	($2,454,000)
57.130	Vaccination Monthly Monitoring Form–Summary Method	480,000	420,000	$34.65	$37.49	$16,632,000	$15,745,800	($886,200)
57.131	Vaccination Monthly Monitoring Form–Patient-Level Method	40,000	20,000	$34.65	$37.49	$1,386,000	$749,800	($636,200)
57.132	N/A-Remove from ICR	41,667	0	$34.65	$37.49	$1,443,750	$0	($1,443,750)
57.133	Patient Vaccination	83,333	83,333	$34.65	$37.49	$2,887,500	$3,124,167	$236,667
57.135	N/A-Remove from ICR	6,000	0	$34.65	$37.49	$207,900	$0	($207,900)
57.136	N/A-Remove from ICR	6,000	0	$34.65	$37.49	$207,900	$0	($207,900)
57.137†	Patient Safety Component--Annual Facility Survey for LTCF	-	104	-	$37.49	-	$3,905	$3,905
57.138†	Laboratory-identified MDRO or CDI Event for LTCF	-	1,000	-	$37.49	-	$37,490	$37,490
57.139†	MDRO and CDI Prevention Process Measures Monthly Monitoring for LTCF	-	88	-	$37.49	-	$3,280	$3,280
57.140†	Urinary Tract Infection (UTI) for LTCF	-	1,125	-	$37.49	-	$42,176	$42,176
57.200	Healthcare Personnel Safety Component Annual Facility Survey	4,800	48,000	$34.65	$37.84	$166,320	$1,816,320	$1,650,000
57.202	Healthcare Worker Survey	10,000	10,000	$34.65	$37.84	$346,500	$378,400	$31,900
57.203	Healthcare Personnel Safety Monthly Reporting Plan	900	900	$34.65	$37.84	$31,185	$34,056	$2,871
57.204	Healthcare Worker Demographic Data	40,000	40,000	$34.65	$37.84	$1,386,000	$1,513,600	$127,600
57.205	Exposure to Blood/Body Fluids	30,000	30,000	$34.65	$37.84	$1,039,500	$1,135,200	$95,700
57.206	Healthcare Worker Prophylaxis/Treatment	1,500	1,500	$34.65	$37.84	$51,975	$56,760	$4,785
57.207	Follow-Up Laboratory Testing	15,000	15,000	$17.25	$17.32	$258,750	$259,800	$1,050
57.208	Healthcare Worker Vaccination History	30,000	30,000	$34.65	$37.84	$1,039,500	$1,135,200	$95,700
57.209	Healthcare Worker Influenza Vaccination	50,000	50,000	$34.65	$37.84	$1,732,500	$1,892,000	$159,500
57.210	Healthcare Worker Prophylaxis/Treatment-Influenza	5,000	5,000	$34.65	$37.84	$173,250	$189,200	$15,950
57.211	Pre-season Survey on Influenza Vaccination Programs for Healthcare Personnel	100	100	$34.65	$37.84	$3,465	$3,784	$319
57.212	Post-season Survey on Influenza Vaccination Programs for Healthcare Personnel	100	100	$34.65	$37.84	$3,465	$3,784	$319
57.213†	Healthcare Personnel Influenza Vaccination Monthly Summary	-	72,000	-	$37.84	-	$2,724,480	$2,724,480
57.300	Hemovigilance Module Annual Survey	1,000	1,000	$34.65	$31.27	$34,650	$31,270	($3,380)
57.301	Hemovigilance Module Monthly Reporting Plan	200	200	$34.65	$31.27	$6,930	$6,254	($676)
57.302	Hemovigilance Module Monthly Incident Summary	12,000	12,000	$34.65	$31.27	$415,800	$375,240	($40,560)
57.303	Hemovigilance Module Monthly Reporting Denominators	3,000	3,000	$34.65	$31.27	$103,950	$93,810	($10,140)
57.304	Hemovigilance Adverse Reaction	10,000	10,000	$34.65	$31.27	$346,500	$312,700	($33,800)
57.305	Hemovigilance Incident	6,000	6,000	$34.65	$31.27	$207,900	$187,620	($20,280)
Total Estimated Annual Cost Burden						$148,138,253	$135,294,367	($12,843,886)

^†This is a new form.

Revision of estimated national annual cost burden of data collection by NHSN data collection form. 2