Information Collection

Perioperative Medication Safety Self-Assessment for Hospitals and Ambulatory Surgical Centers and Targeted Risk-Reduction Tool Development (CDER)

IC 244834 under ICR 201910-0910-010 · OMB 0910-0847.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0847 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ISMP Medication Safety Self Assessment for Perioperative Settings.pdf	Other-Survey Instrument
ISMP Screenshot Webpage.docx	Other-Screenshot Webpage
0847 OMB Approval Memo Perioperative Medication Safety Self Assessment 2020.docx OMB Approval Memo	IC Document

IC Title:

Perioperative Medication Safety Self-Assessment for Hospitals and Ambulatory Surgical Centers and Targeted Risk-Reduction Tool Development (CDER)

Agency IC Tracking Number:

CDER

IC Status: New

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
Other-Survey Instrument			ISMP Medication Safety Self Assessment for Perioperative Settings.pdf		Yes	Yes	Fillable Fileable
Other-Screenshot Webpage			ISMP Screenshot Webpage.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	11,171	11,171
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Approval Memo	0847 OMB Approval Memo Perioperative Medication Safety Self Assessment 2020.docx	12/09/2020

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