57.128 Laboratory Identified or CDI MDRO 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⚠️ Notice: This information collection may be referencing outdated material.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 57.128 Rev 7, 57.128 Laboratory Identified or CDI MDRO Event Form and Instruction
CDC 57.128 Rev 7, Lab ID Event 57.128_LabIDEvent_BLANK.docx Form and Instruction
CDC 57.128 Rev 7, Lab ID Event 57.128_LabIDEvent_BLANK.docx Form and Instruction
57.128 Laboratory-identified MDRO or CDI Event (with revised GI 57.128_LabIDEvent_November_2022.docx Form
57.128 Laboratory-identified MDRO or CDI Event (with revised GI 57.128_LabIDEvent_November_2022.docx Form
57.128_LabIDEvent_November_2022.docx 57.128 Laboratory-identified MDRO or CDI Event (with GISAB edits in tracked changes) IC Document
57.128_LabIDEvent_November_2022.docx 57.128 Laboratory-identified MDRO or CDI Event (with GISAB edits in tracked changes) IC Document

Information Collection (IC) Details

IC Title:	57.128 Laboratory Identified or CDI MDRO Event	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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 and Instruction	CDC 57.128 Rev 7, v8.5	Lab ID Event	57.128_LabIDEvent_BLANK.docx		Yes	Yes	Fillable Fileable
Form	57.128	Laboratory-identified MDRO or CDI Event (with revised GISAB questions)	57.128_LabIDEvent_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: 4,800	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	379,200	379,200
Annual IC Time Burden (Hours)	132,720	132,720
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
57.128 Laboratory-identified MDRO or CDI Event (with GISAB edits in tracked changes)	57.128_LabIDEvent_November_2022.docx	04/25/2023

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