Information Collection

57.112 Ventilator-Associated Event (VAE)

IC 200377 under ICR 201807-0920-002 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CDC 57.112 57.112 Ventilator-Associated Event (VAE)	Form
CDC 57.112 Ventilator-Associated Event (VAE) 57.112_VAE_BLANK.DOCX	Form
G22. Ventilator Associated Event.pdf Att G22_Ventilator-Associated Event	IC Document

IC Title:

57.112 Ventilator-Associated Event (VAE)

Agency IC Tracking Number:

0920-0666

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CDC 57.112	Ventilator-Associated Event (VAE)	57.112_VAE_BLANK.DOCX		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	864,000	864,000
Annual IC Time Burden (Hours)	403,200	403,200
Annual IC Cost Burden (Dollars)	15,990,912	15,990,912

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att G22_Ventilator-Associated Event	G22. Ventilator Associated Event.pdf	08/08/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.