National Sample Survey of Registered Nurses

Forms and Documents

Document Name	Status
Form NSSRN 2018 National Sample Survey of Registered Nurses Questionnaire Form and Instruction	New
NSSRN Contact Experiment Plans_OMB.docx Supplementary Document	2018-01-30
NSSRN_2018 instrument (final).pdf Supplementary Document	2018-01-17
OMB Form 83-I.pdf Supplementary Document	2017-11-08
NSSRN 60 Day FRN.pdf Supplementary Document	2017-11-08
PRA Executive Summary Form_NSSRN.docm Supplementary Document	2017-11-08
NSSRN_FINAL.pdf Supplementary Document	2017-11-08
NSSRN_Infograph.pdf Supplementary Document	2017-11-08
NSSRN_Letters.docx Supplementary Document	2017-11-08
NSSRN_AppendixA.docx Supplementary Document	2017-11-08
Part B - NSSRN 2018 Production OMB.docx Supporting Statement B	2017-11-07
Part A - NSSRN 2018 Production OMB_10-2-17.docx Supporting Statement A	2017-11-07

IC Document Collections

IC ID	Document Title	Status
228947	2018 National Sample Survey of Registered Nurses Questionnaire Form and Instruction	New

ICR Details

OMB Control No: 0607-1002	ICR Reference No: 201711-0607-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: National Sample Survey of Registered Nurses
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/30/2018
	Date Received in OIRA: 11/22/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved
Responses	65,000	0	0
Time Burden (Hours)	28,600	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: Sponsored by the U.S. Department of Health and Human Services’ (HHS) Health Resources and Services Administration’s (HRSA) National Center for Health Workforce Analysis (NCHWA), the National Sample Survey of Registered Nurses (NSSRN) is designed to obtain the necessary data to determine the characteristics and distribution of Registered Nurses (RNs) throughout the United States, as well as emerging patterns in their employment characteristics. These data will provide the means for the evaluation and assessment of the evolving demographics, educational qualifications, and career employment patterns of RNs.

---

Authorizing Statute(s): US Code: 42 USC Section 295k(a)-(b) Name of Law: Public Health Service Act
   US Code: 13 USC Section 8b Name of Law: null
   US Code: 42 USC Section 294n(b)(2)(A) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 28817	06/26/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 55556	11/22/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
2018 National Sample Survey of Registered Nurses Questionnaire	NSSRN	2018 National Sample Survey of Registered Nurses

---

ICR Summary 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	65,000	0	0	65,000	0	0
Annual Time Burden (Hours)	28,600	0	0	28,600	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: New collection of information

---

Annual Cost to Federal Government: $4,700,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 11/22/2017

---