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Form Approved OMB No. 09200666 Exp. Date: 01/31/2021 www.cdc.gov/nhsnHealthcare Personnel Safety Component Annual Facility Survey Page 1 of 2 *required for savingTracking #: Facility ID#: *Facility
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How to fill out 57200 nhsn omb form

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To fill out the 57200 NHSN OMB form, follow these steps:
02
Start by entering the necessary identification information, such as your name, facility name, and contact details.
03
Provide information about the patient, including their demographics and medical history.
04
Specify the date and time of admission and discharge.
05
Describe the reason for admission and the primary diagnosis.
06
Report any secondary diagnoses or comorbidities.
07
Enter details about any surgical procedures performed during the patient's stay, including the date, type, and outcome.
08
Indicate any complications or adverse events experienced by the patient.
09
Include information about any healthcare-associated infections the patient contracted during their stay.
10
Provide data on antibiotic usage and any antibiotic-resistant organisms identified.
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Finally, review the form for accuracy and completeness before submitting it.

Who needs 57200 nhsn omb form?

01
The 57200 NHSN OMB form is required by healthcare facilities and providers who participate in the National Healthcare Safety Network (NHSN) reporting system. This form is used to collect data on patient demographics, diagnoses, procedures, healthcare-associated infections, antibiotic usage, and more. It helps in monitoring and preventing healthcare-associated infections and improving patient safety.
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57200 NHSN OMB form is a form used for reporting data related to healthcare-associated infections to the National Healthcare Safety Network (NHSN) as mandated by the Office of Management and Budget (OMB).
Healthcare facilities such as hospitals, long-term care facilities, and outpatient surgery centers are required to file 57200 NHSN OMB form.
To fill out 57200 NHSN OMB form, healthcare facilities must collect and report data on healthcare-associated infections according to the instructions provided by the NHSN.
The purpose of 57200 NHSN OMB form is to track and monitor healthcare-associated infections in healthcare facilities in order to improve patient safety and quality of care.
Information such as the type of infection, number of cases, and other relevant data related to healthcare-associated infections must be reported on 57200 NHSN OMB form.
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