OMB control number

The AHRQ Safety Program for Methicillin-Resistant Staphylococcus aureus (MRSA) Prevention

OMB 0935-0260 · HHS/AHRQ.

OMB 0935-0260

Latest Forms, Documents, and Supporting Material

Document Name
Form 9.5 Attachment J - Subsequent data pull for 10% of units Form and Instruction
Form 17 Attachment Q: Survey of Patient Safety Culture-HSOPS V.2 Form and Instruction
Form 11 Attachment L: Clinical Outcomes Data for LTC Form and Instruction
Form 10 Attachment K: Clinical Outcomes Data for Surgical Services Form and Instruction
Form 9 Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Form 11 Attachment L: Clinical Outcomes Data for LTC Form and Instruction
Form 10 Attachment K: Clinical Outcomes Data for Surgical Services Form and Instruction
Form 9 Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Form 9 Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Form 9 Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Form 8 TEAM CHECK-UP TOOL – Long-Term Care (LTC) Form and Instruction
Form 6 Team Checkup Tool Form and Instruction
Form 3 Gap Analysis Form and Instruction
Form 2 Attachment I: Survey of Patient Safety Culture – NHSOPS Form and Instruction
Form 1 Attachment H: Survey of Patient Safety Culture – HSOPS Form and Instruction
SSA revised highlighted changes_22.05.17 - updates to HSOPS 22.06.16_mc.docx Supporting Statement A
SSB revised highlighted changes_22.05.17 - updates to HSOPS 6.15.22_mc.docx Supporting Statement B
Att P Schedule of Evaluation Activities.docx Supplementary Document
Att O Completion Guide for LTC Clinical Outcomes Data.docx Supplementary Document
Att N Completion Guide for Surgical Services Clinical Outcomes Data.docx Supplementary Document
Att M Completion Guide for ICU-Non-ICU Clinical Outcomes Data.docx Supplementary Document
Attachment J - Subsequent data pull for 10% of units Form and Instruction
Attachment Q: Survey of Patient Safety Culture-HSOPS V.2 Form and Instruction
Attachment L: Clinical Outcomes Data for LTC Form and Instruction
Attachment K: Clinical Outcomes Data for Surgical Services Form and Instruction
Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Attachment L: Clinical Outcomes Data for LTC Form and Instruction
Attachment K: Clinical Outcomes Data for Surgical Services Form and Instruction
Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
Attachment J: Clinical Outcomes Data for ICU/Non-ICU Form and Instruction
TEAM CHECK-UP TOOL – Long-Term Care (LTC) Form and Instruction
Team Checkup Tool Form and Instruction
Gap Analysis Form and Instruction
Attachment I: Survey of Patient Safety Culture – NHSOPS Form and Instruction
Attachment H: Survey of Patient Safety Culture – HSOPS Form and Instruction

All Historical Document Collections

202209-0935-004 Approved without change	Revision of a currently approved collection	2022-10-19
202107-0935-003 Approved with change	New collection (Request for a new OMB Control Number)	2021-07-26