Nurse Fatigue-Mitigation Education: Does it Change Nurse Sleep Behavior?

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-21FC Attachment E.Consensus Sleep Diary	Form	Unchanged	Available
Form 0920-21FC Consensus Sleep Diary	Form	Unchanged	Repair queued
Form 0920-21FC Attachment D.2 SURVEY FOR IMMEDIATE POST-TRAINING	Form and Instruction	Unchanged	Available
Form 0920-21FC Immediate Post-Training Survey	Form and Instruction	Unchanged	Repair queued
Form 0920-21FC Post-Training (1, 3, and 6-months) Survey	Form and Instruction	Unchanged	Available
Form 0920-21FC Post-Training (1, 3, and 6-months) Survey	Form and Instruction	Unchanged	Repair queued
Form 0920-22FC Attachment D.Baseline Survey	Form and Instruction	Unchanged	Available
Form 0920-22FC Baseline Survey	Form and Instruction	Unchanged	Available
CHANGE REQUEST 0920-1367_Common Form.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-28	Available
CHANGE REQUEST 0920-1367_Common Form.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-02-28	Available
Wong.Privacy Act Determination.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Wong.Privacy Act Determination.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Wong.Privacy Act Checklist_.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Wong.Privacy Act Checklist_.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Wong.AppendixB.OMB.2021.4.30.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Wong.AppendixB.OMB.2021.4.30.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Attachment G.Determination.CIO-HSC.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Attachment G.Determination.CIO-HSC.docx	Supplementary Document	Uploaded 2022-06-16	Available
Attachment F. Public Comments.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Attachment F. Public Comments.docx	Supplementary Document	Uploaded 2022-06-16	Missing upstream
Attachment A.OSH Act.docx	Supplementary Document	Uploaded 2022-06-16	Repair queued
Attachment A.OSH Act.docx	Supplementary Document	Uploaded 2022-06-16	Missing upstream
Supporting Statement B.docx	Supporting Statement B	Uploaded 2022-06-16	Available
Supporting Statement B.docx	Supporting Statement B	Uploaded 2022-06-16	Repair queued
Supporting Statement A Nurse_Fatigue.2022.8.18.docx	Supporting Statement A	Uploaded 2022-08-19	Repair queued
Supporting Statement A Nurse_Fatigue.2022.8.18.docx	Supporting Statement A	Uploaded 2022-08-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
254348	Actigraphy watch training	Instruction	Unchanged
254320	Actigraphy watch Fitting	Other-Actigraphy watch fitting	Unchanged
254319	Consensus Sleep Diary	Form	Unchanged	Attachment E.Consensus Sleep Diary
254319	Consensus Sleep Diary	Form	Unchanged
254318	Immediate Post-Training Survey	Form and Instruction	Unchanged	Attachment D.2 SURVEY FOR IMMEDIATE POST-TRAINING
254318	Immediate Post-Training Survey	Form and Instruction	Unchanged
254317	Post-Training (1, 3, and 6-months) Survey	Form and Instruction	Unchanged	Post-Training (1, 3, and 6-months) Survey
254317	Post-Training (1, 3, and 6-months) Survey	Form and Instruction	Unchanged
254265	Online Nurses Training	Other-Webpage	Unchanged
254264	Baseline Survey	Form and Instruction	Unchanged	Attachment D.Baseline Survey
254264	Baseline Survey	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1367	ICR Reference No: 202502-0920-007
Status: Historical Active	Previous ICR Reference No: 202206-0920-011
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-21FC
Title: Nurse Fatigue-Mitigation Education: Does it Change Nurse Sleep Behavior?
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/10/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/05/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2025	08/31/2025	08/31/2025
Responses	350	0	350
Time Burden (Hours)	341	0	341
Cost Burden (Dollars)	0	0	0

---

Abstract: The purpose of this project is to evaluate the effectiveness of the NIOSH online “Training for Nurses on Shift Work and Long Work Hours”. NIOSH is committed to providing educational materials to employers and workers on workplace health and safety topics. Part of this commitment is regular evaluation of education products to determine if NIOSH-sponsored products are still successful at communicating and translating knowledge, impactful to worker health and safety. This evaluation is supported by NIOSH intramural NORA funding and will evaluate RN sleep health and wellbeing pre- and post-training. NIOSH intends to Discontinue this data collection. However, attempts to perform this action in ROCIS result in an Error Message “The OMB Control Number cannot be Discontinued because it is a Common Form.” NIOSH did not intend to have this data collection approved as a Common Form and this was done in error. This Non-Substantive Change Request is submitted to change the status of this collection and allow the subsequent submission of a Discontinuation. There is no change in burden.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 26517	05/14/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 35780	06/13/2022
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Actigraphy watch Fitting
Actigraphy watch training
Baseline Survey	0920-22FC	Attachment D.Baseline Survey
Consensus Sleep Diary	0920-21FC	Attachment E.Consensus Sleep Diary
Immediate Post-Training Survey	0920-21FC	Attachment D.2 SURVEY FOR IMMEDIATE POST-TRAINING
Online Nurses Training
Post-Training (1, 3, and 6-months) Survey	0920-21FC	Post-Training (1, 3, and 6-months) Survey

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	350	350	0	0	0	0
Annual Time Burden (Hours)	341	341	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The purpose of this project is to evaluate the effectiveness of the NIOSH online “Training for Nurses on Shift Work and Long Work Hours”. NIOSH estimates a total annual response burden of 341 hours for this new information collection.

---

Annual Cost to Federal Government: $276,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  Yes

Description/Changes for Common Form Usage:  NIOSH intends to Discontinue this data collection. However, attempts to perform this action in ROCIS result in an Error Message “The OMB Control Number cannot be Discontinued because it is a Common Form.” NIOSH did not intend to have this data collection approved as a Common Form and this was done in error. This Non-Substantive Change Request is submitted to change the status of this collection and allow the subsequent submission of a Discontinuation. There is no change in burden.

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/05/2025

---