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Perioperative Medication Safety Self-Assessment for Hospitals and Ambulatory Surgical Centers and Targeted Risk-Reduction Tool Development (CDER)
Data To Support Social and Behavioral Research as Used by the Food and Drug Administration
OMB: 0910-0847
IC ID: 244834
OMB.report
HHS/FDA
OMB 0910-0847
ICR 201910-0910-010
IC 244834
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0847 can be found here:
2023-11-03 - No material or nonsubstantive change to a currently approved collection
2022-12-28 - Extension without change of a currently approved collection
Documents and Forms
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
Information Collection (IC) Details
View Information Collection (IC)
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:
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
Federal Enterprise Architecture Business Reference Module
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 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,500
0
1,500
0
0
0
Annual IC Time Burden (Hours)
11,171
0
11,171
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.