57.126 MDRO or CDI Infection Event

[NCEZID] The National Healthcare Safety Network (NHSN)

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form CDC 57.126 57.126 MDRO or CDI Infection Event Form
CDC 57.126 MDRO or CDI Infection Event 57.126_MDROInfectionEvent_BLANK.DOCX Form
CDC 57.126 MDRO or CDI Infection Event 57.126_MDROInfectionEvent_BLANK.DOCX Form
57.126 MDRO or CDI Infection Event (with revised GISAB question 57.126_MDROInfectionEvent_November_2022.docx Form
57.126 MDRO or CDI Infection Event (with revised GISAB question 57.126_MDROInfectionEvent_November_2022.docx Form
57.126_MDROInfectionEvent_November_2022.docx MDRO or CDI Infection Event (with revised GISAB questions in tracked changes) IC Document
57.126_MDROInfectionEvent_November_2022.docx MDRO or CDI Infection Event (with revised GISAB questions in tracked changes) IC Document

Information Collection (IC) Details

IC Title:	57.126 MDRO or CDI Infection Event	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	CDC 57.126	MDRO or CDI Infection Event	57.126_MDROInfectionEvent_BLANK.DOCX		Yes	Yes	Fillable Fileable
Form	57.126	MDRO or CDI Infection Event (with revised GISAB questions)	57.126_MDROInfectionEvent_November_2022.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 720	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	7,920	0	7,920
Annual IC Time Burden (Hours)	4,092	132	3,960
Annual IC Cost Burden (Dollars)	0	-157,054	157,054

Documents for IC

Title	Document	Date Uploaded
MDRO or CDI Infection Event (with revised GISAB questions in tracked changes)	57.126_MDROInfectionEvent_November_2022.docx	04/25/2023

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