Att D-1_ Explanations and Justifications for proposed revisions

National Healthcare Safety Network (NHSN)

OMB Control No. 0920-0666

Revision Request July 2019

Explanations and justifications for proposed revisions to OMB 0920-0666

The proposed ICR is comprised of 40 data collection tools under OMB No. 0920-0666 which will be updated in this revision request. Details related to changes in each NHSN component are provided below:

1. There are ten data collection tools within the patient safety component (PSC) of NHSN being revised within this ICR. (57.103, 57.104, 57.108, 57.111, 57.112, 57.113, 57.114, 57.115, 57.120, 57.126, 57.127, 57.150, and 57.151)

Justification: Ten forms within the NHSN Patient Safety Component are changing with this ICR. Updates were made to the pathogens and susceptibility section for forms (57.111, 57.112, 57.113, 57.114, 57. 115, and 57.120) due to a program-wide name change for the organism from ‘Enterobacter’ to ‘Klebsiella.’ The name change is going into effect in January 2020. Updates were made to the facility water management program section for forms (57.103, 57.150, and 57.151) to include additional response options to gather information on the type of personnel that comprise a facility water management team. These additional options were derived from previous survey responses that were reported in a free-text option choice. An update to question 30 on form 57.103 was made to help identify if antimicrobial administration was routine or rarely conducted in specific neonatal locations within the facility. NHSN will be implementing the new optional NHSN Facility Administrator/Component Contact Change Request Form (57.104), which is designed to streamline changes to the contacts at the facility level responsible for being the primary contact. This form will be made electronically available in January 2020 in the NHSN application. Finally, the number of respondents using the patient safety forms has increased to reflect the actual number of facilities reporting data into NHSN for a more accurate burden estimate.

2. Eight LTCF forms will be updated, two of which (57.138, 57.140), will include an update that will streamline how the facilities document the “Social Security Number” and ‘Resident type’ variables.

Justification: The resident social security number is currently an optional data field on all LTCF event forms. NHSN is not using the data in the analysis, nor to identify individual residents, therefore, a decision was made to remove social security number as an option on the event form. Additionally, the resident type will be auto-populated by the NHSN application based on internal business rules, thereby, decreasing the overall burden of these forms. Additionally, the LTCF Component of NHSN will be introducing the new Respiratory Tract Infection form (57.136). For 2020, prior to introducing the new module and form to NHSN users, the CDC’s Epidemiology Research & Innovations (ERIB) team will use the form to perform field testing of the form variables to explore the utilization, applicability, and data collection burden associated with these variables. This process will inform areas of improvement prior to incorporating the new module, including protocol, forms, and instructions into NHSN.

3. Three form updates to the Dialysis Component (57.500, 57.502, and 57.507).

Justification: Three Dialysis component tools will be updated with this ICR. CDC added and revised multiple questions/options on the surveys to better understand possible risk factors for healthcare-associated infections (HAIs), as well as the patient population they serve for surveillance and prevention purposes. These changes will help inform future policies/guidelines to reduce bloodstream infections (57.500 and 57.507). Similar to the patient safety component, “Klebsiella aerogenes” was added to the dialysis event form (57.502) as an option to the antibiogram/drug susceptibility results. This addition is to align the pathogen section of the dialysis event form to the rest of NHSN. Additionally, three new event-specific event dates were added to the dialysis event form (57.502) to gather more accurate information on dialysis events. There is an increase in the number of reporting facilities due to an increase in their use (57.500, 57.501, 57.502, 57.503, 57.504, 57.505, 57.506, and 57.507).

4. All other form changes include the application of the 2018 annual labor wages to all NHSN components. Additionally, NHSN has re-evaluated the reports used to determine responses per respondent and respondents annually, which accounts for major reductions to the annual burden and assist the program in achieving ultimate burden reduction.

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