Evaluation of Venous Thromboembolism Prevention Practices in U.S. Hospitals

ICR 202102-0920-012

OMB: 0920-1339

Federal Form Document

Forms and Documents
Document
Name
Status
Form
New
Supplementary Document
2021-02-23
Supplementary Document
2021-02-23
Supplementary Document
2021-02-23
Supplementary Document
2021-02-23
Supplementary Document
2021-02-23
Supplementary Document
2021-02-23
Supporting Statement B
2021-02-23
Supporting Statement A
2021-02-23
IC Document Collections
IC ID
Document
Title
Status
245946 New
ICR Details
202102-0920-012
Received in OIRA
HHS/CDC 0920-21AT
Evaluation of Venous Thromboembolism Prevention Practices in U.S. Hospitals
New collection (Request for a new OMB Control Number)   No
Regular 03/26/2021
  Requested Previously Approved
12 Months From Approved
384 0
384 0
18,643 0

Venous thromboembolism (VTE) is an important and growing public health problem. The purpose of this project is to evaluate current VTE prevention practices in U.S. hospitals in order to support a framework for hospital-associated VTE prevention. A random sample of U.S. adult general medical/surgical hospitals will be asked to complete a questionnaire administered electronically through the QualtricsXM platform.

US Code: 42 USC 241 Name of Law: PHSA
  
None

Not associated with rulemaking

  85 FR 73716 11/19/2020
86 FR 16214 03/26/2021
No

1
IC Title Form No. Form Name
Questionnaire none Evaluation of VT Prevention Practices

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 384 0 0 384 0 0
Annual Time Burden (Hours) 384 0 0 384 0 0
Annual Cost Burden (Dollars) 18,643 0 0 18,643 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.

$140,147
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Shari Steinberg 404 639-4942 sxw2@cdc.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/26/2021


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