Change Request Memo

Change Memo for

National Healthcare Safety Network (NHSN)

Surveillance in Healthcare Facilities

(OMB Control No. 0920-0666)

Expiration Date: 11/30/2024

Program Contact

Lauren Wattenmaker

Surveillance Branch

Division of Healthcare Quality Promotion

National Center for Emerging and Zoonotic Infectious Diseases

Centers for Disease Control and Prevention

Atlanta, Georgia 30333

Phone: 404-718-5842

Email: [email protected]

Submission Date: April 2, 2021

The Centers for Disease Control and Prevention (CDC), Division of Healthcare Quality Promotion (DHQP) requests a nonmaterial/non-substantive to the currently approved Information Collection Request:

1. National Healthcare Safety Network (NHSN) Surveillance in Healthcare Facilities (OMB Control No. 0920-0666)

CDC is adding the burden estimates for vaccination data collection instruments in order to provide greater transparency notwithstanding the Paperwork Reduction Act (PRA) waiver for the collection and reporting of vaccination data under Section 321 of the National Childhood Vaccine Injury Act of 1986 (pub. L. 99-660, enacted on November 14, 1986) (NCVIA).

In OMB Control No. 0920-0666, CDC is providing the burden estimates for the following NHSN Influenza Vaccination forms:

1. Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities. Burden estimate of 1 hour for each week the form is completed.

2. Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Long-Term Care Facilities. Burden estimate of 1 hour for each week the form is completed.

3. Weekly Resident Influenza Vaccination Cumulative Summary for Long-Term Care Facilities. Burden estimate of 1 hour for each week the form is completed.

4. Annual Healthcare Personnel Influenza Vaccination Summary in the NHSN Healthcare Personnel Safety Component. Burden estimate of 2 hours.

CDC estimates 1 hour to complete reporting for each week the form is being used. The total burden time will depend upon how long data reporting is required.   

Type of Respondent	Form Name	No. of Respondents	No. Responses per Respondent	Avg. Burden per response (in hrs.)	Total Burden (in hrs.)
Microbiologist	Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities	125	52	1	6500
	Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Long-Term Care Facilities	1,200	52	1	62,400
	Weekly Resident Influenza Vaccination Cumulative Summary for Long-Term Care Facilities	2,500	52	1	130,000
	Annual Healthcare Personnel Influenza Vaccination Summary	5,000	1	2	10,000