57.405 Outpatient Procedure Component - Surgical Site Infection (SSI) 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⚠️ Notice: This information collection may be referencing outdated material.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 57.405 57.405 Outpatient Procedure Component - Surgical Site Infection (SSI) Event Form
CDC 57.405 Outpatient Procedure Component - SSI Denominators 57 405_OPC_SSI_Event Final_November_2022.docx Form
CDC 57.405 Outpatient Procedure Component - SSI Denominators 57 405_OPC_SSI_Event Final_November_2022.docx Form
57 405_OPC_SSI_Event Final_November_2022.docx Outpatient Procedure Component SSI Denominators with GISAB edits in tracked changes IC Document
57 405_OPC_SSI_Event Final_November_2022.docx Outpatient Procedure Component SSI Denominators with GISAB edits in tracked changes IC Document

Information Collection (IC) Details

IC Title:	57.405 Outpatient Procedure Component - Surgical Site Infection (SSI) 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 57.405	Outpatient Procedure Component - SSI Denominators	57 405_OPC_SSI_Event Final_November_2022.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 700	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,500	0	3,500
Annual IC Time Burden (Hours)	2,392	59	2,333
Annual IC Cost Burden (Dollars)	0	-80,973	80,973

Documents for IC

Title	Document	Date Uploaded
Outpatient Procedure Component SSI Denominators with GISAB edits in tracked changes	57 405_OPC_SSI_Event Final_November_2022.docx	04/25/2023

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