Agency Information Collection Activities: Proposed Collection; Comment Request, 4700-4702 [2011-1540]
Download as PDF
<![CDATA[
4700
Federal Register / Vol. 76, No. 17 / Wednesday, January 26, 2011 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:
This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
information collection project:
‘‘Standardizing Antibiotic Use in Longterm Care Settings.’’ In accordance with
the Paperwork Reduction Act, 44 U.S.C.
3501–3520, AHRQ invites the public to
comment on this proposed information
collection.
This proposed information collection
was previously published in the Federal
Register on November 15th, 2010 and
allowed 60 days for public comment. No
comments were received. The purpose
of this notice is to allow an additional
30 days for public comment.
DATES: Comments on this notice must be
received by February 25, 2011.
ADDRESSES: Written comments should
be submitted to: AHRQ’s OMB Desk
Officer by fax at (202) 395–6974
(attention: AHRQs desk officer) or by email at OIRA_submission@omb.eop.gov
(attention: AHRQ’s desk officer).
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUMMARY:
SUPPLEMENTARY INFORMATION:
Proposed Project
mstockstill on DSKH9S0YB1PROD with NOTICES
Standardizing Antibiotic Use in Longterm Care Settings
This project seeks to contribute to
AHRQ’s mission by optimizing
antibiotic prescribing practices in
nursing homes. Nursing homes serve as
one of our most fertile breeding grounds
for antibiotic-resistant strains of
bacteria. Nursing home residents, with
their combination of the effects of
normal aging and multiple chronic
diseases, have relatively high rates of
infection. With high rates of respiratory,
urinary, skin, and other infection comes
VerDate Mar<15>2010
17:27 Jan 25, 2011
Jkt 223001
a very high rate of antibiotic use that
gives rise to Methicillin-resistant
Staphylococcus aureus (MRSA),
Vancomycin-resistant Enterococci
(VRE), fluoroquinolone-resistant strains
of a variety of bacteria, and multi-drug
resistant organisms (MDROs).
Inappropriate antibiotic prescribing
practices by primary care clinicians
caring for residents in long-term care
(LTC) communities is becoming a major
public health concern. Antibiotics are
among the most commonly prescribed
pharmaceuticals in LTC settings, yet
reports indicate that a high proportion
of antibiotic prescriptions are
inappropriate.
In an effort to reduce antibiotic
overprescribing, Loeb and colleagues
developed minimum criteria for the
initiation of antibiotics in LTC setting.
The criteria have been tested in several
studies, but their implementation and
tests of validity have been limited. In
particular, though Loeb and colleagues
developed distinct minimum criteria for
several types of infection (skin and softtissue, respiratory, urinary tract, and
unexplained fever), a rigorous
evaluation has been conducted only for
urinary tract infections.
This project will assess an approach
to using the Loeb criteria that requires
minimal changes in facility procedures
and, therefore, is likely to be widely
adopted by nursing homes. The
intervention makes use of a
Communication and Order Form (COF),
which has been designed by the
researchers and will be used by the
nurses and physicians to guide their
decision-making about whether to order
an antibiotic for a specific resident
experiencing a specific infection.
Twelve nursing homes will
participate in this project with eight
assigned to the intervention and four
serving as controls. The eight
intervention sites will be divided into
two groups of four sites each, with one
group receiving an additional follow-up
training 2 months after the intervention.
The objectives of the study are to:
1. Implement a quality improvement
(QI) intervention program to optimize
antibiotic prescribing practices;
2. Evaluate the effect of the QI
intervention on antibiotic prescribing
practices including validation of the
Loeb minimum criteria; and
3. Develop and execute a
dissemination plan to ensure wide
dissemination of the findings and
recommendations for improving
antibiotic prescribing behaviors in LTC
settings.
This study is being conducted by
AHRQ through its contractor, the
American Institutes for Research (AIR),
PO 00000
Frm 00092
Fmt 4703
Sfmt 4703
pursuant to AHRQ’s statutory authority
to conduct and support research on
healthcare and on systems for the
delivery of such care, including
activities with respect to the quality,
effectiveness, efficiency,
appropriateness, and value of healthcare
services and with respect to quality
measurement and improvement. 42
U.S.C. 299a(a)(1) and (2).
Method of Collection
The following data collection
activities and trainings will be
implemented to achieve the first two
objectives of this project:
1. Loeb Criteria Communication and
Order Form—This form will be
completed by staff in the eight
intervention nursing homes to
determine if the Loeb criteria have been
met. The COF provides a logical
decision model for determining the
need for an antibiotic. Facility staff will
complete the paper form and the data
from the forms will be entered into a
database by the project researchers.
Based on a preliminary review of the
infection logs at 4 nursing homes, we
estimate that staff nurses will complete
an average of 17 COFs per month per
nursing home at the 8 nursing homes
that will use the COF during the 6month intervention period.
2. Medical record reviews (MMR)—To
be conducted by research staff to collect
outcome data to determine antibiotic
prescribing practices and their effects
and to assess the resident’s health and
functional status, which are potentially
important control variables. Outcome
and control variables will be obtained
by monthly chart review and review of
the Nursing Home Minimum Data Set
(MDS) for a period of 9 months: Three
months preceding the initiation of the
QI intervention (for which the charts of
all eligible residents will be abstracted
for a 3 month period at one time), and
every other month during a 6-month
period following the inception of the
intervention (for which the charts of all
eligible residents will be abstracted for
the preceding two months) AHRQ’s
contractor will conduct the data
abstraction at all 12 facilities (treatment
and control). Since this data collection
will not impose a burden on the facility
staff, OMB clearance is not required.
3. Staff training—Prior to
implementation, the staff
(administrators, nurses, and physicians)
at all eight intervention sites will be
trained in the proper use of the Loeb
Criteria COF. Staff at four of the
intervention sites will be trained a
second time 2 months after the initial
training. We estimate that an average of
E:\FR\FM\26JAN1.SGM
26JAN1
4701
Federal Register / Vol. 76, No. 17 / Wednesday, January 26, 2011 / Notices
24 nurses and 2 physicians will be
trained at each nursing home.
4. Pre-implementation semistructured interview—The purpose of
this interview is to gain an
understanding of (1) how the staff and
the department(s) and/or wider facility
perceive quality improvement, in
general; (2) the amount of experience
the site has in QI and its processes for
handling infections; (3) why the facility
decided to adopt the Loeb Criteria COF;
and (4) the facility’s goals for the Loeb
Criteria COP implementation. Four staff
members will be interviewed at each
nursing home: Two champions (likely
the administrator, director of nursing,
and/or the assistant director of nursing),
one line nurse, and one staff physician.
Questions vary by respondent type.
5. Post-training semi-structured
interview—The purpose of this
interview is to measure the staff’s
(1) perceived adequacy of the training;
(2) their reactions to the training; and (3)
their plans for implementation. The
same four persons at each nursing home
who were interviewed for the preimplementation semi-structured
interviews will participate in this
interview. Questions vary by respondent
type.
6. Post-implementation semistructured interview—The purpose of
this interview is to identify
(1) facilitators and barriers to
implementation; (2) how barriers were
overcome; (3) what barriers remain;
(4) perceived impacts of the Loeb
Criteria COP on the use of antibiotics
within the facility; and (5) the facility’s
view on the business case for Loeb
Criteria COP. The same four persons at
each nursing home who participated in
the previous semi-structured interviews
will participate in this interview.
Questions do not vary by respondent
type.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours the nursing
homes’ time to participate in this
project. All of the data collections and
training in Exhibit 1 pertain only to the
eight intervention nursing homes. The
Loeb Criteria COF will be completed
approximately 17 times a month for 6
months (102 total) by staff at each
nursing home and will require about 5
minutes to complete. Staff training will
be attended by all nursing and medical
staff members at each nursing home (an
average of 24 nurses and two physicians
per facility) and will last 1 hour. All
eight intervention facilities will receive
training once at the start of the
intervention and four of the eight
facilities will receive a second training
one month later to see if reinforcement
results in improved performance. The
pre-implementation, post training and
post-implementation semi structured
interviews will be completed by the
same four staff members at each nursing
home consisting of two champions
(likely the administrator, director of
nursing, and/or the assistant director of
nursing), one line nurse, and one staff
physician. Each interview will be
scheduled for 1 hour. The total annual
burden is estimated to be 476 hours.
Exhibit 2 shows the estimated annual
cost burden associated with the
respondents’ time to participate in this
project. The total annual cost burden is
estimated to be $17,508.
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
nursing homes
Form name
Number of
responses per
nursing home
Hours per
response
Total burden
hours
Loeb Criteria COF ...........................................................................................
Staff training .....................................................................................................
Initial Training ..................................................................................................
Re-training .......................................................................................................
Pre-implementation semi-structured interview .................................................
Post training semi-structured interview ............................................................
Post-implementation semi-structured interview ...............................................
8
102
5/60
68
8
4
8
8
8
26
26
4
4
4
1
1
1
1
1
208
104
32
32
32
Total ..........................................................................................................
44
na
na
476
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
nursing homes
Form name
Total burden
hours
Average hourly wage rate *
Total cost
burden
8
68
$33
$2,244
8
4
8
8
8
208
104
32
32
32
36
36
42
42
42
7,488
3,744
1,344
1,344
1,344
Total ..........................................................................................................
mstockstill on DSKH9S0YB1PROD with NOTICES
Loeb Criteria COF ...........................................................................................
Staff training .....................................................................................................
Initial Training ..................................................................................................
Re-training .......................................................................................................
Pre-implementation semi-structured interview .................................................
Post training semi-structured interview ............................................................
Post-implementation semi-structured interview ...............................................
44
476
na
17,508
* Based upon the mean of the average wages, National Compensation Survey: Occupational wages in the United States May 2009, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’ $33 is the average wage for nurses who will complete the COF. $36 is the weighted average
wage of 24 nurses at $33 per hour and 2 physicians at $70 per hour who will be trained. $42 is the weighted average wage of 3 nurses and administrators at $33 per hour and 1 physician at $70 per hour who will be interviewed.
Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the estimated total
and annual cost to the government for
VerDate Mar<15>2010
17:27 Jan 25, 2011
Jkt 223001
funding this project. Although data
collection will require less than one
year, the entire project will span 2 years.
PO 00000
Frm 00093
Fmt 4703
Sfmt 4703
The total cost of this research is
estimated to be $999,554.
E:\FR\FM\26JAN1.SGM
26JAN1
4702
Federal Register / Vol. 76, No. 17 / Wednesday, January 26, 2011 / Notices
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
Cost component
Total cost
Annualized
cost
Project Development ...............................................................................................................................................
Data Collection Activities .........................................................................................................................................
Data Processing and Analysis .................................................................................................................................
Publication of Results ..............................................................................................................................................
Project Management ................................................................................................................................................
Overhead .................................................................................................................................................................
$103,498
361,178
193,830
48,497
65,334
227,217
$51,749
180,589
96,915
24,249
32,667
113,609
Total ..................................................................................................................................................................
999,554
499,777
Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
comments on AHRQ’s information
collection are requested with regard to
any of the following: (a) Whether the
proposed collection of information is
necessary for the proper performance of
AHRQ healthcare research and
healthcare information dissemination
functions, including whether the
information will have practical utility;
(b) the accuracy of AHRQ’s estimate of
burden (including hours and costs) of
the proposed collection(s) 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 upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.
Dated: January 11, 2011.
Carolyn M. Clancy,
Director.
[FR Doc. 2011–1540 Filed 1–25–11; 8:45 am]
BILLING CODE 4160–90–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Control and Prevention (CDC)
announces the aforementioned meeting:
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Time and Date: 1 p.m.–3 p.m., March 9,
2011 (Closed).
Place: National Institute for Occupational
Safety and Health (NIOSH), CDC, 1095
Willowdale Road, Morgantown, West
Virginia 26506, telephone: (304) 285–6143.
Status: The meeting will be closed to the
public in accordance with provisions set
forth in Section 552b(c)(4) and (6), Title 5
U.S.C., and the Determination of the Director,
Management Analysis and Services Office,
CDC, pursuant to Public Law 92–463.
Matters to be Discussed: The meeting will
include the initial review, discussion, and
evaluation of ‘‘Member Conflict Review, PA
07–318.’’
Contact Person for More Information: M.
Chris Langub, PhD, Scientific Review Officer,
Office of Extramural Programs, National
Institute for Occupational Safety and Health,
CDC, 1600 Clifton Road, NE., Mailstop E74,
Atlanta, Georgia 30333; Telephone: (404)
498–2543.
The Director, Management Analysis and
Services Office, has been delegated the
authority to sign Federal Register notices
pertaining to announcements of meetings and
other committee management activities, for
both the Centers for Disease Control and
Prevention, and the Agency for Toxic
Substances and Disease Registry.
Dated: January 17, 2011.
Elaine L. Baker,
Director, Management Analysis and Services
Office, Centers for Disease Control and
Prevention.
Centers for Disease Control and
Prevention
[FR Doc. 2011–1615 Filed 1–25–11; 8:45 am]
BILLING CODE 4163–18–P
mstockstill on DSKH9S0YB1PROD with NOTICES
Centers for Disease Control and
Prevention
Disease, Disability, and Injury
Prevention and Control Special
Emphasis Panel (SEP): Member
Conflict Review, Program
Announcement (PA) 07–318, Initial
Review
In accordance with Section 10(a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92–463), the Centers for Disease
VerDate Mar<15>2010
17:27 Jan 25, 2011
Jkt 223001
PO 00000
Frm 00094
Fmt 4703
Sfmt 4703
Disease, Disability, and Injury
Prevention and Control Special
Emphasis Panel (SEP): Cooperative
Agreement Program for the National
Academic Centers of Excellence in
Youth Violence Prevention (U01),
Funding Opportunity Announcement
(FOA) CE10–004, Initial Review
In accordance with section 10(a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92–463), the Centers for Disease
Control and Prevention (CDC) announce
the following meeting of the
aforementioned meeting:
Times and Dates:
8 a.m.–5 p.m., February 17, 2011 (Closed).
8 a.m.–5 p.m., February 18, 2011 (Closed).
Place: Atlanta Marriot Marquis Hotel, 265
Peachtree Center Avenue, Atlanta, Georgia
30303, Telephone: (404) 521–0000.
Status: The meeting will be closed to the
public in accordance with provisions set
forth in Section 552b(c)(4) and (6), Title 5,
U.S.C., and the Determination of the Director,
Management Analysis and Services Office,
CDC, pursuant to Section 10(d) of Public Law
92–463.
Matters To Be Discussed: The meeting will
include the review, discussion, and
evaluation of applications received in
response to ‘‘Cooperative Agreement Program
for the National Academic Centers of
Excellence in Youth Violence Prevention
(U01), FOA CE10–004, initial review’’.
Agenda items are subject to change as
priorities dictate.
Contact Person for More Information: J.
Felix Rogers, PhD, M.P.H., Extramural
Research Program Office, National Center for
Injury Prevention and Control, CDC, 4770
Buford Highway, NE., Mailstop F–63,
Atlanta, Georgia 30341, Telephone: (770)
488–4334.
The Director, Management Analysis and
Services Office has been delegated the
authority to sign Federal Register notices
pertaining to announcements of meetings and
other committee management activities, for
both the Centers for Disease Control and
Prevention and the Agency for Toxic
Substances and Disease Registry.
E:\FR\FM\26JAN1.SGM
26JAN1
]]>Agencies
[Federal Register Volume 76, Number 17 (Wednesday, January 26, 2011)]
[Notices]
[Pages 4700-4702]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-1540]
[[Page 4700]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Standardizing Antibiotic Use in Long-term Care Settings.''
In accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3520,
AHRQ invites the public to comment on this proposed information
collection.
This proposed information collection was previously published in
the Federal Register on November 15th, 2010 and allowed 60 days for
public comment. No comments were received. The purpose of this notice
is to allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by February 25, 2011.
ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk
Officer by fax at (202) 395-6974 (attention: AHRQs desk officer) or by
e-mail at OIRA_submission@omb.eop.gov (attention: AHRQ's desk
officer).
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Standardizing Antibiotic Use in Long-term Care Settings
This project seeks to contribute to AHRQ's mission by optimizing
antibiotic prescribing practices in nursing homes. Nursing homes serve
as one of our most fertile breeding grounds for antibiotic-resistant
strains of bacteria. Nursing home residents, with their combination of
the effects of normal aging and multiple chronic diseases, have
relatively high rates of infection. With high rates of respiratory,
urinary, skin, and other infection comes a very high rate of antibiotic
use that gives rise to Methicillin-resistant Staphylococcus aureus
(MRSA), Vancomycin-resistant Enterococci (VRE), fluoroquinolone-
resistant strains of a variety of bacteria, and multi-drug resistant
organisms (MDROs). Inappropriate antibiotic prescribing practices by
primary care clinicians caring for residents in long-term care (LTC)
communities is becoming a major public health concern. Antibiotics are
among the most commonly prescribed pharmaceuticals in LTC settings, yet
reports indicate that a high proportion of antibiotic prescriptions are
inappropriate.
In an effort to reduce antibiotic overprescribing, Loeb and
colleagues developed minimum criteria for the initiation of antibiotics
in LTC setting. The criteria have been tested in several studies, but
their implementation and tests of validity have been limited. In
particular, though Loeb and colleagues developed distinct minimum
criteria for several types of infection (skin and soft-tissue,
respiratory, urinary tract, and unexplained fever), a rigorous
evaluation has been conducted only for urinary tract infections.
This project will assess an approach to using the Loeb criteria
that requires minimal changes in facility procedures and, therefore, is
likely to be widely adopted by nursing homes. The intervention makes
use of a Communication and Order Form (COF), which has been designed by
the researchers and will be used by the nurses and physicians to guide
their decision-making about whether to order an antibiotic for a
specific resident experiencing a specific infection.
Twelve nursing homes will participate in this project with eight
assigned to the intervention and four serving as controls. The eight
intervention sites will be divided into two groups of four sites each,
with one group receiving an additional follow-up training 2 months
after the intervention.
The objectives of the study are to:
1. Implement a quality improvement (QI) intervention program to
optimize antibiotic prescribing practices;
2. Evaluate the effect of the QI intervention on antibiotic
prescribing practices including validation of the Loeb minimum
criteria; and
3. Develop and execute a dissemination plan to ensure wide
dissemination of the findings and recommendations for improving
antibiotic prescribing behaviors in LTC settings.
This study is being conducted by AHRQ through its contractor, the
American Institutes for Research (AIR), pursuant to AHRQ's statutory
authority to conduct and support research on healthcare and on systems
for the delivery of such care, including activities with respect to the
quality, effectiveness, efficiency, appropriateness, and value of
healthcare services and with respect to quality measurement and
improvement. 42 U.S.C. 299a(a)(1) and (2).
Method of Collection
The following data collection activities and trainings will be
implemented to achieve the first two objectives of this project:
1. Loeb Criteria Communication and Order Form--This form will be
completed by staff in the eight intervention nursing homes to determine
if the Loeb criteria have been met. The COF provides a logical decision
model for determining the need for an antibiotic. Facility staff will
complete the paper form and the data from the forms will be entered
into a database by the project researchers. Based on a preliminary
review of the infection logs at 4 nursing homes, we estimate that staff
nurses will complete an average of 17 COFs per month per nursing home
at the 8 nursing homes that will use the COF during the 6-month
intervention period.
2. Medical record reviews (MMR)--To be conducted by research staff
to collect outcome data to determine antibiotic prescribing practices
and their effects and to assess the resident's health and functional
status, which are potentially important control variables. Outcome and
control variables will be obtained by monthly chart review and review
of the Nursing Home Minimum Data Set (MDS) for a period of 9 months:
Three months preceding the initiation of the QI intervention (for which
the charts of all eligible residents will be abstracted for a 3 month
period at one time), and every other month during a 6-month period
following the inception of the intervention (for which the charts of
all eligible residents will be abstracted for the preceding two months)
AHRQ's contractor will conduct the data abstraction at all 12
facilities (treatment and control). Since this data collection will not
impose a burden on the facility staff, OMB clearance is not required.
3. Staff training--Prior to implementation, the staff
(administrators, nurses, and physicians) at all eight intervention
sites will be trained in the proper use of the Loeb Criteria COF. Staff
at four of the intervention sites will be trained a second time 2
months after the initial training. We estimate that an average of
[[Page 4701]]
24 nurses and 2 physicians will be trained at each nursing home.
4. Pre-implementation semi-structured interview--The purpose of
this interview is to gain an understanding of (1) how the staff and the
department(s) and/or wider facility perceive quality improvement, in
general; (2) the amount of experience the site has in QI and its
processes for handling infections; (3) why the facility decided to
adopt the Loeb Criteria COF; and (4) the facility's goals for the Loeb
Criteria COP implementation. Four staff members will be interviewed at
each nursing home: Two champions (likely the administrator, director of
nursing, and/or the assistant director of nursing), one line nurse, and
one staff physician. Questions vary by respondent type.
5. Post-training semi-structured interview--The purpose of this
interview is to measure the staff's (1) perceived adequacy of the
training; (2) their reactions to the training; and (3) their plans for
implementation. The same four persons at each nursing home who were
interviewed for the pre-implementation semi-structured interviews will
participate in this interview. Questions vary by respondent type.
6. Post-implementation semi-structured interview--The purpose of
this interview is to identify (1) facilitators and barriers to
implementation; (2) how barriers were overcome; (3) what barriers
remain; (4) perceived impacts of the Loeb Criteria COP on the use of
antibiotics within the facility; and (5) the facility's view on the
business case for Loeb Criteria COP. The same four persons at each
nursing home who participated in the previous semi-structured
interviews will participate in this interview. Questions do not vary by
respondent type.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours the nursing
homes' time to participate in this project. All of the data collections
and training in Exhibit 1 pertain only to the eight intervention
nursing homes. The Loeb Criteria COF will be completed approximately 17
times a month for 6 months (102 total) by staff at each nursing home
and will require about 5 minutes to complete. Staff training will be
attended by all nursing and medical staff members at each nursing home
(an average of 24 nurses and two physicians per facility) and will last
1 hour. All eight intervention facilities will receive training once at
the start of the intervention and four of the eight facilities will
receive a second training one month later to see if reinforcement
results in improved performance. The pre-implementation, post training
and post-implementation semi structured interviews will be completed by
the same four staff members at each nursing home consisting of two
champions (likely the administrator, director of nursing, and/or the
assistant director of nursing), one line nurse, and one staff
physician. Each interview will be scheduled for 1 hour. The total
annual burden is estimated to be 476 hours.
Exhibit 2 shows the estimated annual cost burden associated with
the respondents' time to participate in this project. The total annual
cost burden is estimated to be $17,508.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Form name Number of responses per Hours per Total burden
nursing homes nursing home response hours
----------------------------------------------------------------------------------------------------------------
Loeb Criteria COF............................... 8 102 5/60 68
Staff training.................................. ..............
Initial Training................................ 8 26 1 208
Re-training..................................... 4 26 1 104
Pre-implementation semi-structured interview.... 8 4 1 32
Post training semi-structured interview......... 8 4 1 32
Post-implementation semi-structured interview... 8 4 1 32
---------------------------------------------------------------
Total....................................... 44 na na 476
----------------------------------------------------------------------------------------------------------------
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Form name nursing homes hours wage rate * burden
----------------------------------------------------------------------------------------------------------------
Loeb Criteria COF............................... 8 68 $33 $2,244
Staff training.................................. ..............
Initial Training................................ 8 208 36 7,488
Re-training..................................... 4 104 36 3,744
Pre-implementation semi-structured interview.... 8 32 42 1,344
Post training semi-structured interview......... 8 32 42 1,344
Post-implementation semi-structured interview... 8 32 42 1,344
---------------------------------------------------------------
Total....................................... 44 476 na 17,508
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the average wages, National Compensation Survey: Occupational wages in the United
States May 2009, ``U.S. Department of Labor, Bureau of Labor Statistics.'' $33 is the average wage for nurses
who will complete the COF. $36 is the weighted average wage of 24 nurses at $33 per hour and 2 physicians at
$70 per hour who will be trained. $42 is the weighted average wage of 3 nurses and administrators at $33 per
hour and 1 physician at $70 per hour who will be interviewed.
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated total and annual cost to the
government for funding this project. Although data collection will
require less than one year, the entire project will span 2 years. The
total cost of this research is estimated to be $999,554.
[[Page 4702]]
Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
Annualized
Cost component Total cost cost
------------------------------------------------------------------------
Project Development..................... $103,498 $51,749
Data Collection Activities.............. 361,178 180,589
Data Processing and Analysis............ 193,830 96,915
Publication of Results.................. 48,497 24,249
Project Management...................... 65,334 32,667
Overhead................................ 227,217 113,609
-------------------------------
Total............................... 999,554 499,777
------------------------------------------------------------------------
Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, comments on AHRQ's information collection are requested
with regard to any of the following: (a) Whether the proposed
collection of information is necessary for the proper performance of
AHRQ healthcare research and healthcare information dissemination
functions, including whether the information will have practical
utility; (b) the accuracy of AHRQ's estimate of burden (including hours
and costs) of the proposed collection(s) 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 upon the respondents, including the use of automated
collection techniques or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection. All comments will become a matter of
public record.
Dated: January 11, 2011.
Carolyn M. Clancy,
Director.
[FR Doc. 2011-1540 Filed 1-25-11; 8:45 am]
BILLING CODE 4160-90-M
