OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals

OMB 0920-0852 · HHS/CDC.

OMB 0920-0852

Preventing healthcare-associated infections (HAIs) and improving antimicrobial use (AU) are CDC and national priorities. An extension of the prevalence survey’s existing OMB approval is sought to allow a repeat HAI and AU Prevalence Survey to be performed in 2020. A repeat survey will allow assessment of changes in HAI and AU prevalence, pathogen distribution, and quality of antimicrobial prescribing. These data will also allow CDC and its partners to continue to monitor HAI and AU trends, to measure progress in meeting national targets, and to further refine prevention strategies.

The latest form for Prevalence Survey of Healthcare Associated Infections (HAIs) and Antimicrobial Use in U.S. Acute Care Hospitals expires 2022-10-31 and is listed under ICR 201908-0920-006.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Patient Information Form (PIF)Form
Healthcare Facility Assessment (HFA)Form
Att_I_d_AQUA UTI_Form_Aug22.docx Supplementary Document
Att_I_c_AQUA CAP_Form_Aug22.docx Supplementary Document
Att_I_b_AQUA Fluoroquinolone Form_Aug22.docx Supplementary Document
Att_I_a_AQUA Vancomycin Form_Aug22.docx Supplementary Document
Att_H_AQUA General Patient Assessment Form_Aug22.docx Supplementary Document
Att_G_AQUA Case Eligibility Form_Aug22.docx Supplementary Document
Att_E_HAI Form_Aug22.docx Supplementary Document
Att_C1_EIP HFA_Aug22.docx Supplementary Document
Change request_HPPS_HAI and AU_2023_08_02_2022.docx Justification for No Material/Nonsubstantive Change
Attachment_I_c_AQUA CAP_Form.docx Supplementary Document
HAIPS PTA Signed 2019.pdf Supplementary Document
Attachment_I_d_AQUA UTI_Form.docx Supplementary Document
Attachment_I_b_AQUA Fluoroquinolone Form.docx Supplementary Document
Attachment_M_Draft example of Informaton document distributed to HCF.pdf Supplementary Document
Attachment_L_ Non-research_Determination.pdf Supplementary Document
Attachment_K_NCHS_Consultation.pdf Supplementary Document
Attachment_J_HFA_PIF_Instructions.pdf Supplementary Document
Attachment_I_a_AQUA Vancomycin Form.docx Supplementary Document
Attachment_H_AQUA General Patient Assessment Form.docx Supplementary Document
Attachment_G_AQUA Case Eligibility Form.docx Supplementary Document
Attachment_F_AU Form.docx Supplementary Document
Attachment_E_HAI Form.docx Supplementary Document
Attachment_B_60-Day_0920-0852 Published Federal Register.pdf Supplementary Document
Attachment_A2_ARRA.pdf Supplementary Document
Attachment_A_Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document
SSB_0920_0852_Extension_2021_final.docxSupporting Statement B
SSA_0920_0852_Extension_2021_final_ICRO.docxSupporting Statement A
Patient Information Form (PIF) Form
Healthcare Facility Assessment (HFA) Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202207-0920-011 No material or nonsubstantive change to a currently approved collection 2022-08-03 Approved without change
202112-0920-006 Extension without change of a currently approved collection 2021-12-27 Approved without change
201908-0920-006 Extension without change of a currently approved collection 2019-09-04 Approved with change
201612-0920-005 No material or nonsubstantive change to a currently approved collection 2016-12-08 Approved without change
201608-0920-019 Revision of a currently approved collection 2016-09-29 Approved without change
201407-0920-018 No material or nonsubstantive change to a currently approved collection 2014-08-08 Approved without change
201407-0920-009 No material or nonsubstantive change to a currently approved collection 2014-07-22 Improperly submitted and continue
201406-0920-008 No material or nonsubstantive change to a currently approved collection 2014-06-20 Improperly submitted and continue
201310-0920-002 Reinstatement with change of a previously approved collection 2013-10-21 Approved without change
201304-0920-003 Extension without change of a currently approved collection 2013-04-03 Improperly submitted and continue
201303-0920-004 Extension without change of a currently approved collection 2013-03-08 Improperly submitted and continue
201102-0920-010 No material or nonsubstantive change to a currently approved collection 2011-02-15 Approved without change
201004-0920-002 New collection (Request for a new OMB Control Number) 2010-04-05 Approved with change

OMB Details

Healthcare Facility Assessment (HFA)

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form noneHealthcare Facility AssessmentPaper OnlyForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.