57.108 Primary Bloodstream Infection (BSI)

The National Healthcare Safety Network (NHSN)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Document Name Document Type
Form CDC 57.108 57.108 Primary Bloodstream Infection (BSI) Form
CDC 57.108 Primary blood stream infection COVID-19_FieldAddition_57.108_PrimaryBSI_BLANK.docx Form
5. Central Line Associated Bloodstream Infection.pdf Att G5_Central Line-Associated Urinary Tract Infection IC Document

Information Collection (IC) Details

IC Title:	57.108 Primary Bloodstream Infection (BSI)	Agency IC Tracking Number:	0920-0666

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CDC 57.108	Primary blood stream infection	COVID-19_FieldAddition_57.108_PrimaryBSI_BLANK.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,775	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	28,875	0	28,875
Annual IC Time Burden (Hours)	18,769	481	18,288
Annual IC Cost Burden (Dollars)	572,591	0	572,591

Documents for IC

Title	Document	Date Uploaded
Att G5_Central Line-Associated Urinary Tract Infection	5. Central Line Associated Bloodstream Infection.pdf	09/16/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.