[Federal Register: November 26, 2003 (Volume 68, Number 228)]
[Notices]
[Page 66439-66440]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr26no03-62]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-04-07]


Proposed Data Collections Submitted for Public Comment and
Recommendations

    In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995 for opportunity for public comment on
proposed data collection projects, the Centers for Disease Control and
Prevention (CDC) will publish periodic summaries of proposed projects.
To request more information on the proposed projects or to obtain a
copy of the data collection plans and instruments, call the CDC Reports
Clearance Officer on (404) 498-1210.
    Comments are invited on: (a) Whether the proposed collection of
information is necessary for the proper performance of the functions of
the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on respondents,
including through the use of automated collection techniques or other
forms of information technology. Send comments to Seleda Perryman, CDC
Assistant Reports Clearance Officer, 1600 Clifton Road, MS-D24,
Atlanta, GA 30333. Written comments should be received within 60 days
of this notice.
    Proposed Project: National Surveillance System for Hospital Health
Care Workers (NaSH) (0920-0417)--Renewal--National Center for
Infectious Diseases (NCID), Centers for Disease Control and Prevention
(CDC).

Background

    CDC has developed a surveillance system now called the National
Surveillance System for Health Care Workers (NaSH) that focuses on
surveillance of exposures and infections among hospital-based health
care workers (HCWs). NaSH includes standardized methodology for various
occupational health issues. It is a collaborative effort of CDC,
National Center for Infectious Diseases, Division of Healthcare Quality
and Promotion, Division of Viral Hepatitis, Division of Tuberculosis
(TB) Elimination; CDC, National Center for HIV, STD, and TB Prevention,
National Immunization Program (NIP), and National Institute for
Occupational Safety and Health (NIOSH). NaSH consists of modules for
collection of data about various occupational issues. Baseline
information about each HCW such as demographics and vaccination history
is collected when the HCW is enrolled in the system. Results of routine
tuberculin skin test (TST) are collected and entered in the system
every time a TST is placed and read; follow-up information is collected
for HCWs with a positive TST. When a HCW is exposed to blood/bloodborne
pathogen, to a vaccine-preventable disease (VPD), or to an infectious
TB patient/HCW, epidemiologic data are collected about the exposure.
For HCWs exposed to a bloodborne pathogen (i.e., HIV, HCV, or HBC) and
for susceptible HCWs exposed to VPDs, additional data are collected
during follow-up visits. Once a year, hospitals complete a survey to
provide denominator data and every 2-5 years, the hospitals perform a
survey to assess the level of underreporting of needlesticks (HCW
Survey). Optionally, hospitals may collect information about HCW
noninfectious occupational injuries such as acute musculoskeletal
injuries. Data are entered into the software and transmitted on
diskette to CDC. No HCW identifiers are sent to CDC. This system is
protected by the Assurance of Confidentiality (308d).
    Data collected in NaSH have assisted hospitals, HCWs, health care
organizations, and public health agencies. This system has allowed CDC
to monitor national trends, to identify newly emerging hazards for
HCWs, to assess the risk of occupational infection, and to evaluate
preventive measures, including engineering controls, work practices,
protective equipment, and post-exposure prophylaxis to prevent
occupationally acquired infections. Hospitals that volunteer to
participate in this system benefit by receiving technical support and
standardized methodologies, including software, for conducting
surveillance activities on occupational health.
    This system was developed and piloted in large teaching hospitals
(RFP-200-94-0834(P) and RFP-200-96-0524(P)). The first pilot included
four hospitals and the second, five. After the refinement pilot in an
additional 13 hospitals (PA-786 and interagency agreements),
participation in NaSH became voluntary. The system is being made
available to all healthcare facilities in the United States wishing to
participate voluntarily in the project. We anticipate no more than 75
hospitals participating by the end of fiscal year 2004 and potentially
85 by the end of fiscal year 2005. The burden estimate has been reduced
from that projected 3 years ago because of a drop in the number of
facilities actively participating in NaSH. To participate in NaSH,
hospitals are required to provide information on all exposures to

[[Page 66440]]

infectious agents, baseline information on the exposed HCWs, as well as
the underreporting and hospital surveys.
    A new component of NaSH will be forms for collecting information on
exposures and injuries associated with smallpox vaccination. It uses a
reporting form based on the blood exposure form already approved for
use in NaSH and a root-cause analysis form. This is a paper-based
reporting system that can be used by NaSH and non-NaSH facilities.
    A different number of facilities will be completing each of the
separate forms listed in the table. The number of respondents is the
number of facilities. The number of responses per respondent varies
with the form.
    The maximum total burden hours may reach 86,720. (The total
estimated maximum cost to respondents may be $1,300,800 [$15 an hour
for hospital personnel who will collect/input the data]). Since all of
the data collection activities except the HCW survey, outlined in the
modules are currently routinely done by infection control practitioners
and employee health, personnel health, and/or occupational medicine
personnel in hospitals with existing well established surveillance
programs, the only additional burden for some hospitals participating
in the NaSH system is the time needed for data entry and transmission
of data to CDC. Thus, the real burden hours and burden cost could be
significantly less. The only activity that may not be routinely
performed by the hospitals is the survey to assess underreporting of
needlesticks (HCW survey).
    This study is scheduled for implementation in late 2003 and 2004.
There are no costs to respondents.

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                                                     Number of       Number of     Avg. burden/
                      Form                          respondents     responses/     response  (in   Total burden
                                                    (hospitals)     respondent        hours)        (in hours)
----------------------------------------------------------------------------------------------------------------
Baseline Information............................              75             250           10/60           3,125
TST:
    TST Result..................................              30             200           10/60           1,000
    Positive TST................................              20             100           30/60           1,000
Exposure to Blood:
    Exposure....................................              50             100           60/60           5,000
    Exposure (NaSH ``Lite/abbreviated form).....              10              20           30/60             100
    Postexposure prophylaxis....................              50              80           20/60           1,333
    Follow-up...................................              50              60           15/60             750
Exposure during smallpox vaccination:
    Exposure event..............................              20               1           10/60               3
    Root cause analysis.........................              20               1           60/60              20
Exposure to VPD:
    Summary.....................................              50               3           20/60              50
    HCW.........................................              50              10           20/60             167
Exposure to TB..................................              25               3           60/60              75
Noninfectious Injury............................              25              20           20/60             167
HCW Survey......................................              25             500           10/60           2,083
Hospital Survey.................................              75               1               2             150
                                                 -----------------
Total...........................................  ..............  ..............  ..............          14,986
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    Dated: November 18, 2003.
Laura Yerdon Martin,
Acting Director, Executive Secretariat, Centers for Disease Control and
Prevention.
[FR Doc. 03-29524 Filed 11-25-03; 8:45 am]

BILLING CODE 4163-18-P