0920-1282 Form 4 - HAI/AR Performance Measures (SHARP Project V; P

[OADPS] The Performance Measures Project: Improving Performance Measurement and Monitoring by CDC Programs

[NCEZID] - Data Reporting [Form 4] [revision 2024-2026] [03-17-2025]

[OADPS/NCEZID] HAI/IR Programs (2023-2025)

OMB: 0920-1282

Document [pdf]
Download: pdf | pdf
Confidential

HAI/AR Performance Measures (Project Firstline), Aug 2024 - Dec 2024
Page 1

Project Firstline Data Quality Check
Jurisdiction

__________________________________

 
Project Firstline
 
Errors identified during submission:

Yes
No

Performance Measure Flagged for Follow-up Summary of Issues Please confirm that the issue has been addressed:
PM PFL 1: Number and types of staff supporting Project Firstline ______ ______ ______
PM PFL 2 (Jan 1, 2022 - July 31 2022): Number and characteristics of individuals trained, by training opportunity
(funded by Project Firstline) ______ ______ ______
PM PFL 3: Types and extent of promotional activities for Project Firstline ______ ______ ______
SHARP V.1: Types and extent of targeted communication activities on local HAI/AR threats (funded by Project
Firstline) ______ ______ ______
Notes/comments to CDC:

 
Thank you for submitting your Project Firstline Performance Measures. No items have been flagged for follow-up.
 
 
If you have any questions, concerns, or issues with the items indicated above please contact
[email protected] with "Project Firstline Performance Measures - Data Closeout" in the subject line.
 

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HAI/AR Performance Measures (Project Firstline), Aug 2024 - Dec 2024
Page 2

PFL PM1 - PARTNERSHIPS AND VENDOR RELATIONSHIPS

PFL PM1 - PARTNERSHIPS AND VENDOR RELATIONSHIPS
In order to enhance capacity to educate, train, and communicate with frontline healthcare workers, jurisdictions are
encouraged to establish partnerships in support of project goals.
Today's Date
__________________________________
Did you engage with external partners to accomplish PFL activities during this reporting period? (e.g., local HDs,
health systems, nonprofit or academic institutions, etc.) 
Yes
No
Please specify the types of partners you have you engaged to accomplish PFL activities during this reporting period
and for what purpose: (select all that apply)
PFL training or
education efforts

PFL
marketing/promotion
activity (including
educational material
or messaging
development/
dissemination)

Communication of a
specific HAI threat to
HCWs (e.g. an
outbreak)

Continuing education
credit provision (e.g.
CME, CNE, and CHES
credits)

Local or district health
departments
Academic institutions/partners
Non-profit organizations
(non-academic)
Local hospital associations
Health systems
Professional association/society
Other
 Please specify 'other' type of  partner(s) used for PFL training or education efforts:
__________________________________
 Please specify 'other' type of  partner(s) used for PFL marketing/promotion activity (including educational material or
messaging development/disseminated:
__________________________________
 Please specify 'other' type of  partner(s) used for communication of HAI threats:
__________________________________
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 Please specify 'other' type of  partner(s) used for continuing education credit provision:
__________________________________
Did your jurisdiction use a third-party vendor to accomplish PFL activities during the reporting period? Third-party
vendors are considered any organizations contracted to complete specific deliverables.    
Yes
No

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HAI/AR Performance Measures (Project Firstline), Aug 2024 - Dec 2024
Page 4

PFL PM2 - TRAININGS CONDUCTED

 
PFL PM2 - TRAININGS CONDUCTED  
One form should be completed for EACH training. Information about training format and
content, audience, and evaluation will be requested. If you have more than one training to
report, select "Save and Add New Instance" at the end of the form and a blank form will
appear to enter information on the next training.
Note: Since Project Firstline allows for tailored approaches to training, we acknowledge the
types of training in each jurisdiction will vary. Please include BOTH longer training events and
shorter training events (e.g., webinars or teleconference calls; intentionally adding Project
Firstline training into existing meetings or site visits). If events that span more than one day
or more than one session and the participant group largely comprises a consistent group of
people in each day or session, report this grouping of trainings as one single, cumulative
training event (a "series"). There is a question that will ask you to specify whether the event
was "a series" in the form.
NOTE: If you have more than 10 trainings to report, you have the option to bulk upload the
trainings. If you would like to use the bulk upload form, please download the form through the
SAMS SDX system (https://transfer1.cdc.gov) or the SharePoint site (ELC Reporting). Once the
form is completed, it will need to be uploaded to the SAMS SDX system in the appropriate
location within the upload folder for your jurisdiction. Please find specific instructions on how
to download/uploads the bulk upload form from the SAMS SDX system on the SharePoint site
(ELC Reporting). 
Today's Date

__________________________________

Did your health department hold a training event in
the reporting period (August 1, 2024 - December 31,
2024) ? 

Yes
No

If you have more than 10 trainings to report, do you
wish to report the trainings using the bulk upload
form for the reporting period (August 1, 2024 December 31, 2024)?

Yes
No

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Page 5

Training Event Characteristics
Training delivery methods used:

Please specify other delivery methods utilized:

Where was the recording posted?

Please specify other delivery methods utilized:

Was this a one-time event or a series?
(Consider your event a series if the same group of
people, more or less, attended the various sessions in
the series.)

Live event only
Live event, recorded, and then posted for later
viewing
Asynchronous only event (e.g., self-paced video
viewing on LMS, social media, or website)
Other delivery method

__________________________________
Our organization's website
YouTube
Learning Management System
YouTube
Other

__________________________________
One-time event
Series

Date of training event (If it's a multi-day training,
input the start date, but do not report the training
until the series is complete)

__________________________________

What date was the asynchronous training originally
made available online? (please estimate if you do not
know the exact date)

__________________________________

How many completions of the asynchronous training
occurred within the 12-month reporting period? (August
1, 2024 - December 31, 2024)

__________________________________

Who conducted the training?

Please specify the Grantee or Designee

Type of training event:

Please give a brief description of the event
(e.g. train-the-trainer series that spanned across
multiple dates; interactive webinar with facilitated
discussion; live Q&A session reposted for asynchronous
viewing afterwards)

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ELC-funded Health Department
Grantee or Designee

__________________________________
Train the trainer (i.e. training individuals who
will then turn around and train batches of people
within an organization. The primary purpose of the
training should be to formally prepare individuals
to be trainers for future training sessions.)
Direct training of healthcare personnel or public
health staff

__________________________________

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How did you use data to inform the development or
implementation of this training event? (select all
that apply)

Please specify how data was used to inform this
training event:
How did you use data to inform the development or
implementation of this asynchronous training? (select
all that apply)
 

Please specify how data was used to inform this
training event:
Please select the data source(s) used to inform this
training event: (select all that apply)

Please describe any other data source used to inform
this training event:
Infection control topics covered in the training?
(select all that apply):

Please describe any other topics covered:

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To identify topic for training
To identify audiences/settings for the training
that are priority
To understand/address specific learning needs of
the intended audience
To adapt training content
To understand how best to disseminate/publicize
the training event
Data was not used
Other

__________________________________
To identify topic for training
To identify audiences/settings for the training
that are priority
To understand/address specific learning needs of
the intended audience
To adapt training content
To understand how best to disseminate/publicize
the training event
Data was not used
Other

__________________________________
NHSN data
Our jurisdiction's learning needs assessment
ICAR data
Outbreak/surveillance data
Training evaluation data (e.g. prior participant
feedback)
Other

__________________________________
Overview of infection control
Basic scient topics (e.g. microbiology basics,
variants, etc.)
Risk recognition
Reservoirs
Source Control
pread of infections (i.e. transmission)
Personal Protective Equipment (PPE)
Hand Hygiene
Engineering controls (e.g. ventilation, barriers)
Environmental infection control (e.g. cleaning and
disinfection, waste disposal, UV lights)
Injection safety
Other topic(s) not listed above

__________________________________

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Total length of training in hours.
For short trainings, you may use decimals/fractions
(e.g. 30 min = 0.5 hours; 15 min = 0.25 hours; 5 min =
0.08 hours). For a series, please report the total
time spent in all sessions of the series:  

__________________________________
(Please estimate if you do not know the exact
number of hours administered)

 
What length of time in hours does it take to complete
this asynchronous training? (on average)
For short trainings, you may use decimals/fractions
(e.g. 30 min = 0.5 hours; 15 min = 0.25 hours; 5 min =
0.08 hours). For a series, please report the total
time spent in all sessions of the series.  
What was the total attendance at the event?
(Please estimate if you do not know the exact number
in attendance) 
In what language was information delivered for this
training? (Select all that apply)

Please specify other language used:
 

__________________________________
(Please estimate if you do not know the exact
number of hours administered)

__________________________________
(Please estimate if you do not know the exact
number in attendance)
English
Spanish
Other

__________________________________

Participant Characteristics
Indicate professional roles in attendance, specifying
number in attendance for each provider type in the
subsequent fields.
If you do not know the exact attendance by
practitioner type, please estimate.  

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Physician
Physician assistant
Advanced practice nurse (e.g., nurse practitioner)
Registered nurse (RN)
Licensed practical nurse (LPN)
Nursing/medical assistant
Dentist/Dental Hygienist
Technician (e.g., radiology, surgical, pharmacy,
etc.)
Therapist (e.g., physical, occupational,
respiratory, etc.)
Pharmacist
Environmental/facility services (e.g., EVS staff,
facility managers, facility engineers)
Social services and community services (e.g.,
social workers, community health workers,
residential/outpatient mental health treatment
staff)
Healthcare administrator (e.g., clinic or hospital
directors, CEOs)
Non-clinical support staff (e.g., HR personnel,
marketing/communications staff, quality/patient
safety staff, clerical staff)
Emergency medical technician/paramedic
Laboratory staff
Public health professional
Other

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Type of public health professionals in attendance

Communications Specialist
Epidemiologist
HAI/AR Program Coordinator
Health Educator
Infection Preventionist
Public Health Nurse
Other public health professional

Professional Roles in Attendance
Total number of physicians in attendance

Total number of physician assistants in attendance

Total number of advanced practice nurses (e.g., nurse
practitioner) in attendance

Total number of registered nurses (RN) in attendance

Total number of licensed practical nurses (LPN) in
attendance

Total number of nursing/medical assistants in
attendance

Total number of dentists/dental hygienists in
attendance

Total number of technicians (e.g., radiology,
surgical, pharmacy, etc.) in attendance

Total number of therapist (e.g., physical,
occupational, respiratory, etc.) in attendance

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__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

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Total number of pharmacists in attendance

Total number of environmental/facility service
professionals in attendance

Total number of social and community service
professionals in attendance

Total number of healthcare administrators in
attendance

Total number of non-clinical support staff in
attendance

Total number of emergency medical technician/paramedic
in attendance

Total number of laboratory staff in attendance

Total number of public health professionals in
attendance

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

'Other' Professional Roles
Please specify the other Professional Role 1 in
attendance
Total number of other professional role 1 in
attendance 

Please specify the other Professional Role 2 in
attendance
Total number of other Professional Role 2 in
attendance 

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__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

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Please specify the other Professional Role 3 in
attendance
Total number of other Professional Role 3 in
attendance

Please specify the other Professional Role 4 in
attendance
Total number of other professional role 4 in
attendance 

Please specify the other Professional Role 5 in
attendance
Total number of other Professional Role 5 in
attendance 

Please specify the other Professional Role 6 in
attendance
Total number of other Professional Role 6 in
attendance 

Please specify the other Professional Role 7 in
attendance
Total number of other Professional Role 7 in
attendance 

Please specify the other Professional Role 8 in
attendance
Total number of other Professional Role 8 in
attendance 

Please specify the other Professional Role 9 in
attendance
Total number of other Professional Role 9 in
attendance 

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__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

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Please specify the other Professional Role 10 in
attendance
Total number of other Professional Role 10 in
attendance 

Indicate workplace settings represented by training
attendees, specifying number of individuals in
attendance representing each workplace setting. 
For example, if 4 physicians from an acute care
hospital setting are in attendance, enter "4" for this
category. If you do not know the exact attendance by
setting, please estimate.  

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)
Academic institution (university, community
college, etc.)
Acute care hospital
Critical access hospital
Long-term acute care hospital or inpatient
rehabilitation facility
Skilled nursing facility (nursing home)
Assisted living facility
Pharmacy
Dental facility
Home health
Health department
Outpatient dialysis facility (outpatient)
Outpatient/ambulatory care (e.g., medical,
surgical, behavioral health clinic)
Other

Workplace Settings in Attendance
Total number of individuals in attendance from an
academic institution (university, community college,
etc.)

Total number of individuals in attendance from acute
care hospitals:

Total number of individuals in attendance from
critical access hospitals:

Total number of individuals in attendance from
long-term acute care hospital or inpatient
rehabilitation facilities:

Total number of individuals in attendance from skilled
nursing facilities (nursing homes):

Total number of individuals in attendance from
assisted living facilities:

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__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

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 Total number of individuals in attendance from
pharmacies:

Total number of individuals in attendance from dental
facilities:

 Total number of individuals in attendance from home
health facilities:

Please specify the type of individuals in attendance
from heath department(s):

Total number of individuals in attendance from state
health departments:

Total number of individuals in attendance from local
health departments:

Total number of individuals in attendance from tribal
health departments:

Total number of individuals in attendance from
territorial health departments:

Total number of individuals in attendance from
outpatient dialysis facilities (outpatient):

Total number of individuals in attendance from
outpatient/ambulatory care facilities:

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)
State health department
Territorial health department
Local health department
Tribal health department

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________
(Please estimate if you do not know the exact
number in attendance)

'Other' Setting Types
Please indicate other Workplace Setting 1

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__________________________________

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Total number of individuals in attendance from other
Workplace Setting 1

Please indicate other Workplace Setting 2

Total number of individuals in attendance from other
Workplace Setting 2

Please indicate other Workplace Setting 3

Total number of individuals in attendance from other
Workplace Setting 3

Please indicate other Workplace Setting 4

Total number of individuals in attendance from other
Workplace Setting 4

Please indicate other Workplace Setting 5

Total number of individuals in attendance from other
Workplace Setting 5

Please indicate other Workplace Setting 6

Total number of individuals in attendance from other
Workplace Setting 6

Please indicate other Workplace setting 7

Total number of individuals in attendance from other
Workplace Setting 7

Please indicate other Workplace Setting 8

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__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

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Total number of individuals in attendance from other
Workplace Setting 8

Please indicate other Workplace Setting 9

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

Total number of individuals in attendance from other
Workplace Setting 9

Please indicate other Workplace Setting 10

__________________________________
(Please estimate if you do not know the exact
number in attendance)

__________________________________

Total number of individuals in attendance from 'other'
setting type 10:

__________________________________
(Please estimate if you do not know the exact
number in attendance)

Use of CDC-Developed PFL Resource(s)
Did you use Project Firstline materials developed by
the CDC in this training or to guide training session
development or implementation? (e.g., PFL training
videos, PFL facilitator's toolkit)

Yes
No

 
Please indicate the CDC developed PFL resource(s) used below (select all that apply):
In English

In Spanish

Facilitator Toolkit Guide
Session Feedback Form
Facilitator Self-Assessment Form
Micro-Learn discussion guides
Interactive resources (e.g.,
Diarrhea Dilemma, Fidgeting
Felix Gets an IV)
CDC created PFL Videos (e.g.,
Recognizing Risks in Healthcare,
Inside Infection Control series,
etc.)
Posters, infographics, or fact
sheets

Participant Feedback

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Please fill out the following information about participants' change in knowledge, recommendation of the training,
and intent to implement information following the training.
Note: We recognize that your post-training evaluation questions may have asked about the following information
using different language and/or response options. Please enter information about change in knowledge, intent to
implement training information, and training recommendation to the best of your ability. Use the following examples
on how to recode your data, if necessary.
EX1: Likert scale of 'strongly disagree' to 'strongly agree' --> 'strongly disagree' and 'disagree' should be recoded to
'No', if there is a neutral option recode as 'Unsure', 'agree' and 'strongly agree' should be recoded to 'Yes'.
EX2: Likert scale of 'poor' to 'excellent' --> 'poor' should be recoded as 'No', and 'excellent' should be recoded as
'Yes'.
EX3: Likert scale of 'very unlikely' to 'very likely' --> 'very unlikely' and 'unlikely' should be recoded as 'No', 'likely'
and 'very likely' should be recoded as 'Yes'.
Remember that these are just examples of what your jurisdiction may have used and should be tailored as needed.
Change in Knowledge
Was information about participant change in knowledge
collected?

Yes
No

Total number of participants who provided a response
about understanding of the training topic(s):

__________________________________

Total number of participants who expressed improved
understanding of training topic(s) ('Yes'):

__________________________________

Total number of participants who did not express
improved understanding of training topic(s) ('No'):

__________________________________

Total number of participants who are 'Unsure' about if
their understanding of the training topic(s) changed:

__________________________________

Recommend Training to a Colleague
Was information about recommending this training to a
colleague collected?

Yes
No

Total number of participants who provided a response
about recommending the training to a colleague:

__________________________________

Total number of participants who would recommend the
training to a colleague ('Yes'):

__________________________________

Total number of participants who would not recommend
the training to a colleague ('No'):

__________________________________

Total number of participants who are 'Unsure' about
recommending the training to a colleague:

__________________________________

Intent to Implement Training Information
Was information about intent to implement training
information collected?

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Yes
No

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Total number of participants who provided a response
about their intent to implement training information:

__________________________________

Total number of participants who intend to implement
training information ('Yes'):

__________________________________

Total number of participants who do not intend to
implement training information ('No'):

__________________________________

Total number of participants who are 'Unsure' about
their intent to implement training information:

__________________________________

Continuing Education Credits
Were continuing education credits relevant to the
healthcare workforce (e.g. CME, CNE, and CHES credits)
offered for this training?

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Yes
No

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HAI/AR Performance Measures (Project Firstline), Aug 2024 - Dec 2024
Page 17

PFL PM3 - PROMOTIONAL ACTIVITIES

PFL PM3 - PROMOTIONAL ACTIVITIES
In order to better understand the marketing methods used for Project Firstline and quantify the reach of these
activities, you will be asked to provide information about the type and extent of promotional activities for Project
Firstline that occurred in the full year reporting period (August 1, 2024 - December 31, 2024). Promotional activities
asked about in this reporting include social media posts, webpages, and marketing or promotional emails.
Today's Date

__________________________________

Social Media
Did your organization conduct social media activity?

Yes
No

What language(s) were used for social media activity?
(Select all that apply)

English
Spanish
Other

Please specify what other language was used:

What social media platforms were used?

__________________________________
Facebook
Twitter
Instagram
LinkedIn
Youtube

How many impressions did Project Firstline related
Facebook posts generate during the reporting period
(collectively)?

__________________________________

How many impressions did Project Firstline related
Twitter tweets generate during the reporting period
(collectively)?

__________________________________

How many impressions did Project Firstline related
Instagram posts generate during the reporting period
(collectively)?

__________________________________

How many impressions did Project Firstline related
LinkedIn posts generate during the reporting period
(collectively)?

__________________________________

How many impressions did Project Firstline related
Youtube videos developed by your jurisdiction generate
during the reporting period?

__________________________________

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Website
Did your organization post or share any PFL-related
content on a website that you manage?
How many pageviews did all of your PFL-related website
or webpage content generate during the reporting
period (collectively)? 
What language(s) were used for PFL-related website
content? (including resources posted on website)?
Select all that apply.
Please specify what other language was used:  

Yes
No

__________________________________

English
Spanish
Other

__________________________________

Email
Did your organization send any email blasts that
included promotion (e.g., advertising trainings and/or
links PFL information/resources) for anything related
to PFL during the reporting period? 

Yes
No

What language(s) were used for PFL-related promotional
email communications? Select all that apply.

English
Spanish
Other

Please specify what other language was used:  

Approximately how many people (i.e., email addresses)
received PFL-related email communications during the
reporting period? (You do not need to have
confirmation that they opened the email to report
it) 

__________________________________

__________________________________

Other Marketing/Promotion Methods
Do you have other marketing/promotion methods to
report?
Please list "other" Method 1 used:

Total number of individuals reached with Method 1:

Please list "other" Method 2 used:

Total number of individuals reached with Method 2:

Please list "other" Method 3 used:

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Yes
No

__________________________________

__________________________________

__________________________________

__________________________________

__________________________________

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Total number of individuals reached with Method 3:

Please list "other" Method 4 used:

__________________________________

__________________________________

Total number of individuals reached with Method 4:

Please list "other" Method 5 used:

__________________________________

__________________________________

Total number of individuals reached with Method 5:

__________________________________

Use of CDC-developed materials
Did your organization use any CDC-developed
promotional materials during this reporting period?

Yes
No

Promotional materials may have been used in emails,
social media posts, on PFL websites, or through other
communication channels.
*Note that this should only include materials that
were developed by CDC and used by your organization,
and should be limited to those used in PFL-promotional
activities
Which types of CDC-developed promotional materials did you use?
Indicate the type and language(s) of any materials that you used below:
(Please check all that apply)
English Version

Spanish Version

CDC- Developed Social media
graphics/gifs
CDC- Developed Infographics
CDC- Developed PFL videos

Coordination
Did your jurisdiction coordinate with any local public
health departments on PFL promotional activities? (If
you are a local health department, your response
should reflect coordination with other local health
departments). 

03/14/2025 12:54pm

Yes
No

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HAI/AR Performance Measures (Project Firstline), Aug 2024 - Dec 2024
Page 20

PFL PM4 - LOCAL HAI/AR THREAT COMMUNICATION

PFL PM4 - LOCAL HAI/AR THREAT COMMUNICATION
Today's Date

__________________________________

Did your jurisdiction communicate about a specific
local HAI threat in your locality or region to
frontline healthcare workers during this reporting
period? (Note: remember that any communications
reported here should have used SHARP funding)

Yes
No

Please select the HAI threat(s) your jurisdiction
communicated about. (Select all that apply)

Bloodborne pathogens (e.g., hepatitis B, hepatitis
C, HIV)
Candida auris
CAUTI
CLABSI
Clostridoides difficile (i.e., C. diff)
COVID-19
General HAI Prevention
Healthcare-Associated Pneumonias (excluding
respiratory viruses)
Legionella
MRSA
Respiratory viral infections, excluding COVID-19
(e.g., influenza, Respiratory Syncytial Virus)
Other

Please specify the other HAI threat(s) your
jurisdiction communicated about.
Thinking about your response to the prior question,
how was the local HAI threat communicated to
healthcare workers? (i.e. method of dissemination).
Please select all that apply.

Please specify the other HAI threat(s) your
jurisdiction communicated about to healthcare workers.
In which language(s) did communication about local HAI
threat(s) occur? (Select all that apply)

Please specify what other language was used.

03/14/2025 12:54pm

__________________________________
Through partners networks
Social media
Town Hall
Promotional campaign
Training
Other

__________________________________
English
Spanish
Other

__________________________________

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Page 21

To which settings was the local HAI threat(s)
communicated? (select all that apply)

Please specify the other setting 1:

Please specify the other setting 2:

Please specify the other setting 3:

Please specify the other setting 4:

Please specify the other setting 5:

Key message(s) of communication about local HAI
threat(s): (select all that apply)

Please describe other key message(s) used in you
communication about the local HAI/AR threat.

03/14/2025 12:54pm

Acute care hospital
Critical access hospital
Long-term acute care hospital or inpatient
rehabilitation facility
Skilled nursing facility (nursing home)
Assisted living facility
Dialysis facility
Dental facility
Other outpatient facility, please specify
Home health
Other

__________________________________

__________________________________

__________________________________

__________________________________

__________________________________
Reservoir or where the threat tends to live
How the threat spreads
Who is most susceptible to the threat
Actions healthcare workers can take to assess risk
of threat
Actions healthcare workers can take to eliminate
or stop the spread of threat
State or region-specific information on disease
threat (e.g., situation update, location of cases,
timeframe of outbreak, etc.)
Reporting procedures or requirements (e.g., how to
report to state lab, epi programs, or within a
facility)
Other

__________________________________

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