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

Latest forms, documents, and information collections
Document	Type
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

Historical document collections
Reference	Filing	Received	Concluded	Action
202209-0935-004	Revision of a currently approved collection	2022-10-19		Approved without change
202107-0935-003	New collection (Request for a new OMB Control Number)	2021-07-26		Approved with change