OMB control number

Standardizing Antibiotic Use in Long-term Care Setting

OMB 0935-0177 · HHS/AHRQ.

OMB 0935-0177

Latest Forms, Documents, and Supporting Material

Document Name
Form Form #5 Post-implementation semi-structured interview Form and Instruction
Form Form #4 Post training semi-structured interview Form and Instruction
Form Form #3 Pre-implementation semi-structured interview Form and Instruction
Form Form #2 Staff training Form and Instruction
Form Form #1 Loeb Criteria COF Form and Instruction
Waiver of Consent-TAMU.pdf Supplementary Document
Waiver of Consent-AIR.pdf Supplementary Document
IRB Approval-TAMU.pdf Supplementary Document
IRB Approval-AIR.pdf Supplementary Document
HIPPA-WAIVER-SAUL-TAMU.pdf Supplementary Document
Supporting Statement Part B -- Standardizing Antibiotic Use in LTC Settings 4-18-2011.doc Supporting Statement B
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document
Attachment J-Consent Form for Interviews.doc Supplementary Document
Attachment I-Information Sheet.doc Supplementary Document
Attachment H -- Federal Register Notice.pdf Supplementary Document
Attachment C-Medical Record Data Abstraction Form.doc Supplementary Document
Supporting Statement Part A -- Standardizing Antibiotic Use in LTC Settings 4-18-2011.doc Supporting Statement A
Post-implementation semi-structured interview Form and Instruction
Post training semi-structured interview Form and Instruction
Pre-implementation semi-structured interview Form and Instruction
Staff training Form and Instruction
Loeb Criteria COF Form and Instruction

All Historical Document Collections

201102-0935-001

2011-02-15