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
Form Phase 4_PIF_201412 Att E_Patient Information Form (PIF)	Form	Unchanged	Available
Form Phase 4_HFA_201411 Att D_Healthcare Facility Assessment (HFA)	Form	Unchanged	Available
Non-sub change request 0920-0852.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-12-08	Available
Att. N - Multistate Point-Prevalence Survey of Health Care–Associated Infections.pdf	Supplementary Document	Uploaded 2016-12-08	Available
Att. M - Methodology for estimating national prevalance for OMB 0920-0852.docx	Supplementary Document	Uploaded 2016-12-08	Available
Att L - Non-research determination.pdf	Supplementary Document	Uploaded 2016-09-19	Available
SSB 0920-0852 Revision.docx	Supporting Statement B	Uploaded 2016-09-19	Repair queued
Att H - NCHS Consultation.rtf	Supplementary Document	Uploaded 2016-09-19	Available
Att I - Informational Document.pdf	Supplementary Document	Uploaded 2016-09-19	Available
Att B - 60 Day FRN.pdf	Supplementary Document	Uploaded 2016-09-19	Available
Att C - ARRA.docx	Supplementary Document	Uploaded 2016-09-19	Available
Attachment A 42 USC 241.pdf	Supplementary Document	Uploaded 2013-09-25	Available
SSA 0920-0852 Revision.doc	Supporting Statement A	Uploaded 2016-09-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192452	Att E_Patient Information Form (PIF)	Form	Unchanged
192451	Att D_Healthcare Facility Assessment (HFA)	Form	Unchanged

ICR Details

OMB Control No: 0920-0852	ICR Reference No: 201612-0920-005
Status: Historical Active	Previous ICR Reference No: 201608-0920-019
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0852
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: 12/12/2016
	Date Received in OIRA: 12/08/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	12/31/2019	12/31/2019
Responses	6,400	0	6,400
Time Burden (Hours)	1,860	0	1,860
Cost Burden (Dollars)	0	0	0

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Abstract: The goal of this survey is to determine the prevalence of HAIs in hospital patients, types of HAIs and causative pathogens, nature and extent of antimicrobial use in hospitals, prevalence of inappropriate antimicrobial use and opportunities for improvement in antimicrobial use in hospitals, and prevalence of antimicrobial resistance among pathogens causing HAIs.

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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
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 45164	07/12/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 66965	09/29/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Att D_Healthcare Facility Assessment (HFA)	Phase 4_HFA_20141114	HAI & Antimicrobial Use Prevalence Survey Healthcare Facility Assessment (HFA)
Att E_Patient Information Form (PIF)	Phase 4_PIF_20141218	Patient Information Form (PIF)

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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	6,400	6,400	0	0	0	0
Annual Time Burden (Hours)	1,860	1,860	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden reduction of 1890 hours is because it is expected that a survey will only happen once in the coming three years. The previous approval included the completion of two surveys in a three year period. In addition, the number of hospitals is being reduced from 500 to 300.

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Annual Cost to Federal Government: $1,549,916

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? No

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: 12/08/2016

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