Att D-1_ Explanations and Justifications for proposed revisions

National Healthcare Safety Network (NHSN)

OMB Control No. 0920-0666

Revision Request May 2016

Explanations and justifications for proposed revisions to OMB 0920-0666

Twenty-two collection tools previously approved under OMB No. 0920-0666 are being revised to some extent in this revision request. In addition, nineteen forms are being added and one form is being removed. Proposed program changes are explained below.

1. Significant updates to annual facility surveys (57.103, 57.137, 57.150, 57.151, 57.300, and 57.500)

Justification: Based on user feedback and internal reviews of the annual facility surveys it was determined that questions and response options be amended, removed, or added to fit the evolving uses of the annual facility surveys. The surveys are being increasingly used to help intelligently interpret the other data elements reported into NHSN. Currently the surveys are used to appropriately risk adjust the numerator and denominator data entered into NHSN while also guiding DHQP decisions on future division priorities for prevention.

2. Pediatric Ventilator-Associated Event (PedVAE) surveillance will be added to NHSN (57.113)

Justification: The NHSN PedVAE Form was developed amid increasing interest in the public health impact of conditions and complications in mechanically-ventilated neonates and children in acute care hospitals, long term acute care hospitals, and inpatient rehabilitation facilities. PedVAE surveillance will extend NHSN’s current VAE surveillance to pediatric populations (currently, VAE surveillance is only conducted in adult locations). PedVAE surveillance will provide a standardized, evidence-based surveillance method for identifying and tracking incidence and outcomes of ventilator-associated conditions in children in US healthcare facilities. These data may be used by facilities to identify areas where prevention and patient safety efforts may be improved.

3. Custom Event surveillance will be added to NHSN (57.115)

Justification: The NHSN Custom Event Form for reporting of healthcare-associated infections other than CLABSI, CAUTI, VAP, VAE, and SSI was developed amid increasing interest in the public health impact of infections in acute care hospitals, long term acute care hospitals, and inpatient rehabilitation facilities. The Custom Event Form is used by healthcare facilities as part of a standardized, evidence-based surveillance method for identifying and tracking incidence and outcomes of healthcare-associated infections in US healthcare facilities. These data may be used by facilities to identify areas where prevention of healthcare-associated infections may be improved.

4. Adult Sepsis surveillance will be added to NHSN (57.129)

Justification: The NHSN Adult Sepsis Module was developed amid increasing interest in the public health impact of sepsis. The Adult Sepsis module provides a standardized, evidence-based surveillance method for identifying and tracking incidence and outcomes of sepsis among adults in US healthcare facilities. These data may be used by facilities to identify areas where sepsis management may be improved. Data may also be used by public health authorities to identify regions and facilities with poor sepsis outcomes and target interventions accordingly.

5. One new survey was added to the Hemovigilance Component (57.306)

Justification: Non-acute care facilities can now report to the NHSN Hemovigilance Module. All participating facilities complete an Annual Facility Survey. This new form contains questions specific to non-acute care facilities. The inclusion of non-acute care facilities will broaden the scope of facilities reporting to the Hemovigilance Module. This will allow for more robust data collection to identify emerging trends in transfusion related adverse events among these facilities.

6. One existing form was removed (57.304) and fourteen new specific adverse reaction forms were added to the Hemovigilance Component (57.306, 57.307, 57.308, 57.309, 57.310, 57.311, 57.312, 57.313, 57.314, 57.315, 57.316, 57.317, 57.318, 57.319, 57.320)

Justification: The Adverse Reaction form within the Hemovigilance Component was removed (57.304) and instead split into 14 reaction-specific forms to reduce the length of form. The forms include general questions and reaction-specific questions. Splitting the form prevents facilities from reading through questions that do not pertain to the transfusion reaction they are submitting.

7. One new survey was added to the Dialysis Component (57.507)

Justification: Dialysis centers that provide training and support for patients who undergo hemodialysis and/or peritoneal dialysis in their own homes have different practices than centers that provide in-center hemodialysis. The existing “Outpatient Dialysis Center Practices Survey” was tailored to in-center hemodialysis practices and could not be completed correctly by facilities that do not offer that type of care. Therefore a new survey has been created to collect information specific to facilities that support home dialysis patients. Practice information being collected includes:

• Information about the center’s affiliation, medical records systems, and isolation practices

• Patient and staff census

• Vaccination practices

• Hepatitis screening practices

• Practices related to cannulation and cleaning of vascular accesses as well as peritoneal catheters

8. All other NHSN data collection form revisions.

Justification: A number of minor revisions, updates, and clarifications have been made to 22 NHSN data collection forms. See Attachment D-2 for itemized NHSN data collection forms revisions and justifications. Resulting burden revisions are itemized in Attachments D-3 and D-4.

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