[Federal Register Volume 67, Number 91 (Friday, May 10, 2002)]
[Notices]
[Pages 31811-31813]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 02-11709]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Program Announcement 02143]


Validating the Effectiveness of a Hand Hygiene Intervention 
Program in Healthcare Facilities; Notice of Availability of Funds

A. Purpose

    The Centers for Disease Control and Prevention (CDC) announces the 
availability of fiscal year (FY) 2002 funds for a cooperative agreement 
program for Validating the Effectiveness of a Hand Hygiene Intervention 
Program in Healthcare Facilities. This program addresses the ``Healthy 
People 2010'' focus areas of Access to Quality Health Services and 
Immunization and Infectious Diseases.
    The purpose of the program is to demonstrate the impact of a 
specific hand hygiene intervention program in a group of healthcare 
facilities in which no such hand hygiene program previously existed. 
The hand hygiene intervention program to be evaluated was developed in 
collaboration with CDC by the Chicago Antimicrobial Resistance Project 
(CARP). The goals of this program are to: (1) Evaluate the 
reproducibility of the CARP hand hygiene intervention program in 
healthcare facilities in which no such hand hygiene program previously 
existed; (2) evaluate the impact of the program on the incidence of 
isolation of antimicrobial resistant microorganisms; and (3) evaluate 
the suitability of this program to be developed into a public health 
product that can be widely promoted to healthcare facilities 
nationwide.

B. Eligible Applicants

    Applications may be submitted by public and private nonprofit 
organizations and by governments and their agencies; that is, 
universities, colleges, research institutions, hospitals, other public 
and private nonprofit organizations, State and local governments or 
their bona fide agents, including the District of Columbia, the 
Commonwealth of the Northern Mariana Islands, American Samoa, Guam, the 
Federated States of Micronesia, the Republic of the Marshall Islands, 
and the Republic of Palau, and federally recognized Indian tribal 
governments, Indian tribes, or Indian tribal organizations. Faith-based 
organizations are eligible for this award.

    Note: Title 2 of the United States Code section 1611 states that 
an organization described in section 501(c)(4) of the Internal 
Revenue Code that engages in lobbying activities is not eligible to 
receive Federal funds constituting an award, grant or loan.

C. Availability of Funds

    Approximately $197,830 is available in FY 2002 to fund one award. 
It is expected that the award will begin on or about August 1, 2002 and 
will be made for a 12-month budget period within a project period of 
one year. The funding estimate may change.
    Continuation awards within an approved project period will be made 
on the basis of satisfactory progress as evidenced by required reports 
and the availability of funds.

Use of Funds

    Equipment may be purchased with cooperative agreement funds. 
However, the equipment proposed should be appropriate and reasonable 
for the activity to be conducted. The applicant, as part of the 
application process, should provide: (1) A justification for the need 
to acquire the equipment; (2) the description of the equipment; (3) the 
intended use of the equipment; and (4) the advantages/disadvantages of 
purchase versus lease of the equipment (if applicable). Requests for 
equipment purchases will be reviewed and approved only under the 
condition that the National Center for Infectious Diseases, Division of 
Health Quality Promotion, will retain the right to request return of 
all equipment which is in operable condition and was purchased with 
cooperative agreement funds at the conclusion of the project period.

Funding Preferences

    1. Funding preference will be given to applicants affiliated with 
integrated healthcare delivery networks (such as hospital ``chains'' or 
managed care organizations which operate their own healthcare 
facilities).
    2. Funding preference will be given to healthcare delivery networks 
that have between four and ten healthcare facilities in close 
geographic proximity to one another that share a common administration 
and electronic information systems, including at least two long-term 
care facilities.
    3. Funding preference will be given to applicants who have already 
identified a person that has a demonstrated background in infection 
control in healthcare facilities who can be designated to work full-
time on this project.
    4. Funding preference will be given to applicants who demonstrate a 
willingness to model, in collaboration with CDC, their hand hygiene 
intervention program after the CARP hand hygiene intervention program.
    5. Funding preference will be given to applicants who have existing 
infrastructure and experience to perform active surveillance for 
healthcare-associated infections and antimicrobial resistance using 
methodology consistent with the National Nosocomial Infections 
Surveillance System (NNIS).
    6. Funding preference will be given to applicants who have 
installed alcohol-based handrub dispensers in all patient care areas of 
facilities which will participate in the project.

D. Program Requirements

    In conducting activities to achieve the purpose of this program, 
the recipient will be responsible for the activities under 1. Recipient 
Activities, and CDC will be responsible for the activities listed under 
2. CDC Activities.
1. Recipient Activities
    a. In collaboration with CDC, develop and implement a formal hand 
hygiene program in multiple healthcare facilities which has the 
following components:
    (1) Regular educational presentations. At a minimum, educational 
presentations will be given annually to each healthcare worker. The 
interactive presentation uses an audience response system, an 
educational tool which actively engages the audience and allows 
participants to respond to the speaker and compare their own response 
with that of others. Components of the presentation include: review of 
the Hospital Infection Control Practice Advisory Committee's hand 
hygiene guideline, review of hospital policy related to hand hygiene 
and infection control, current hand antisepsis options for healthcare 
workers, data on hospital-specific hand hygiene adherence rates, 
benefits of alcohol-based hand rubs, importance of wearing gloves, 
effect of artificial nails on hand antisepsis, rings as a risk factor 
for healthcare worker hand contamination, and generalized hand care; 
including use of lotions. The presentation also includes two 
accompanying handouts: an individual, pocket-sized bottle of alcohol 
hand rub, and a fact sheet with questions and

[[Page 31812]]

answers regarding alcohol-based hand rubs.
    (2) Displays/Visuals.
    (i) Poster campaign using specific templates provided by the CDC
    (ii) Infection control game utilizing questions and answers 
pertaining to hand hygiene
    (iii) Distribution of promotional items with hand hygiene messages 
(e.g. buttons, key chains, pens, and mugs)
    (3) Motivational Items.
    (i) Feedback of hand hygiene adherence rates to clinical areas and 
groups
    (ii) Recognition of achievements
    b. Perform observational prospective hand hygiene surveillance 
using a structured protocol in every participating facility.
    c. Measure antimicrobial resistance rates before during and after 
implementation of the program using the methods of the Antimicrobial 
Use and Resistance (AUR) component of the National Nosocomial Infection 
Surveillance system.
    d. In collaboration with CDC, develop a plan to evaluate cost-
effectiveness of the intervention.
2. CDC Activities
    a. Collaborate, as appropriate, with the recipient in all stages of 
the program, and provide programmatic and technical assistance.
    b. Assist in data collection, analysis, and interpretation of data 
from the project.
    c. Participate in improving program performance through 
consultation based on information and activities of other projects.
    d. Provide scientific collaboration for appropriate aspects of the 
program, preventive measures, and program strategies.
    e. Assist in the reporting and dissemination of research and other 
results and relevant healthcare quality prevention education and 
training information to appropriate Federal, State, and local agencies, 
healthcare providers, the scientific community, and prevention and 
service organizations with an interest in healthcare quality, and the 
general public.
    f. Assist in the development of a research protocol for 
Institutional Review Board (IRB) review by all cooperating institutions 
participating in the research project. The CDC IRB will review and 
approve the protocol initially and on at least an annual basis until 
the research project is completed.

E. Content

Letter of Intent (LOI)

    An LOI is optional for this program. The narrative should be no 
more than three double-spaced pages, printed on one side, with one inch 
margins, and unreduced font. Your letter of intent will be used to 
enable CDC to determine the level of interest in the program 
announcement. Your letter of intent should identify Program 
Announcement Number 02143, and include the following information: (1) 
Name and address of institution, and (2) name, address, telephone 
number, e-mail address, and fax number of a contact person.

Applications

    Use the information in the Program Requirements, Other 
Requirements, and Evaluation Criteria sections to develop the 
application content. Your application will be evaluated on the criteria 
listed, so it is important to follow them in laying out your program 
plan. The narrative should be no more than 25 double-spaced pages, 
printed on one side, with one inch margins, and unreduced font.
    1. Provide a line-item budget and narrative justification for all 
requested costs. The budget should be consistent with the purpose, 
objectives and research activities, and include:
    a. Line-item breakdown and justification for all personnel, i.e., 
name, position title, annual salary, percentage of time and effort, and 
amount requested.
    b. For each contract: (1) Name of proposed contractor; (2) 
breakdown and justification for estimated costs; (3) description and 
scope of activities to be performed by contractor; (4) period of 
performance, (5) method of contractor selection (e.g., sole-source or 
competitive solicitation); and (6) method of accountability.
    c. A description of any financial and in-kind contributions from 
nonfederal sources.
    Additionally, include a one page, single-spaced, typed abstract. 
The heading should include the title of the cooperative agreement, 
project title, organization, name and address, project director, and 
telephone number. This abstract should include a workplan identifying 
activities to be developed, activities to be completed, and a time-line 
for completion of these activities.

F. Submission and Deadline

Letter of Intent (LOI)

    On or before June 1, 2002, submit the LOI to the Grants Management 
Specialist identified in the ``Where to Obtain Additional Information'' 
section of this announcement.

Application

    Submit the original and two copies of PHS 5161-1 (OMB Number 0920-
0428). Forms are available at the following Internet address: 
www.cdc.gov/od/pgo/forminfo.htm or in the application kit. On or before 
July 14, 2002, submit the application to: Technical Information 
Management-PA02143, Procurement and Grants Office, Centers for Disease 
Control and Prevention, 2920 Brandywine Rd, Room 3000, Atlanta, GA 
30341-4146.
    Deadline: Applications shall be considered as meeting the deadline 
if they are received on or before the deadline date.
    Late Applications: Applications which do not meet the criteria 
above are considered late applications, will not be considered, and 
will be returned to the applicant.

G. Evaluation Criteria

    Applicants are required to provide measures of effectiveness that 
will demonstrate the accomplishment of the various identified 
objectives of the cooperative agreement. Measures of effectiveness must 
relate to the performance goals as stated in section ``A. Purpose'' of 
this announcement. Measures must be objective and quantitative and must 
measure the intended outcome. These measures of effectiveness shall be 
submitted with the application and shall be an element of evaluation.
    Each application will be evaluated individually against the 
following criteria by an independent review group appointed by CDC.
1. Background and Need (10 points)
    The extent to which the applicant demonstrates a strong 
understanding of this program for validating the effectiveness of a 
hand hygiene intervention program in healthcare facilities. The extent 
to which the applicant illustrates the need for this cooperative 
agreement program. The extent to which the applicant presents a clear 
goal for this cooperative agreement that is consistent with the 
described need.
2. Capacity (30 points)
    The extent to which the applicant demonstrates that it has the 
expertise, facilities, and other resources necessary to accomplish the 
program requirements, including curricula vitae of key personnel and 
letters of support from any participating organizations

[[Page 31813]]

and institutions. In particular, the degree to which the applicant 
demonstrates a healthcare delivery network which includes adequate 
numbers of facilities in close geographic proximity to one another that 
share common administration and information systems, and who 
demonstrate a willingness to fully participate.
3. Operational Plan (40 points)
    a. The extent to which the applicant presents clear, time-phased 
objectives that are consistent with the stated program goal and a 
detailed operational plan outlining specific activities that are likely 
to achieve the objective. The extent to which the plan clearly outlines 
the responsibilities of each of the key personnel. (35 points)
    b. The degree to which the applicant has met the CDC Policy 
requirements regarding the inclusion of women, ethnic, and racial 
groups in the proposed research. This includes: (1) The proposed plan 
for the inclusion of both sexes and racial and ethnic minority 
populations for appropriate representation; (2) the proposed 
justification when representation is limited or absent; (3) a statement 
as to whether the design of the study is adequate to measure 
differences when warranted; and (4) a statement as to whether the plans 
for recruitment and outreach for study participants include the process 
of establishing partnerships with community(ies) and recognition of 
mutual benefits. (5 points)
4. Evaluation Plan (15 points)
    The extent to which the applicant presents a scientifically valid 
plan for monitoring the impact of the intervention, including, but not 
limited to, cost effectiveness.
5. Measures of Effectiveness (5 points)
    The extent to which the applicant provides Measures of 
Effectiveness that will demonstrate the accomplishment of the various 
identified objectives of the cooperative agreement. Measures must be 
objective/quantitative and must measure the intended outcome.
6. Budget (Not scored)
    The extent to which the applicant presents a reasonable detailed 
budget with a line-item justification and any other information to 
demonstrate that the request for assistance is consistent with the 
purpose and objectives of this cooperative agreement program.
7. Human Subjects (Not scored)
    The extent to which the application adequately addresses the 
requirements of Title 45 CFR Part 46 for the protection of human 
subjects.

H. Other Requirements

Technical Reporting Requirements

    Provide CDC with original plus two copies of:
    1. Semiannual progress reports.
    2. Financial status report, no more than 90 days after the end of 
the budget period.
    3. Final financial and performance reports, no more than 90 days 
after the end of the project period.
    4. Applicants are required to provide measures of effectiveness 
that will demonstrate the accomplishment of the various identified 
objectives of the cooperative agreement.
    Send all reports to the Grants Management Specialist identified in 
the ``Where to Obtain Additional Information'' section of this 
announcement.
    The following additional requirements are applicable to this 
program. For a complete description of each, see Attachment I of this 
announcement.

AR-1  Human Subjects Requirements
AR-2  Requirements for Inclusion of Women and Racial and Ethnic 
Minorities in Research
AR-7  Executive Order 12372 Review
AR-10  Smoke-Free Workplace Requirements
AR-11  Healthy People 2010
AR-12  Lobbying Restrictions
AR-15  Proof of Non-Profit Status
AR-22  Research Integrity

I. Authority and Catalog of Federal Domestic Assistance Number

    This program is authorized under section 301(a) and 317(k)(2) of 
the Public Health Service Act, [42 U.S.C. sections 241(a) and 
247b(k)(2)], as amended. The Catalog of Federal Domestic Assistance 
number is 93.283.

J. Where To Obtain Additional Information

    This and other CDC announcements can be found on the CDC home page 
Internet address--http://www.cdc.gov Click on ``Funding'' then ``Grants 
and Cooperative Agreements.''
    If you have questions after reviewing the contents of all the 
documents, business management technical assistance may be obtained 
from: Rene' Benyard, Grants Management Specialist, Centers for Disease 
Control and Prevention, Procurement and Grants Office, Acquisition and 
Assistance, Branch B, 2920 Brandywine Road, Room 3000, Mailstop K-75, 
Atlanta, GA 30341-4146, Telephone number: (770) 488-2722, E-mail 
address: [email protected].
    For program technical assistance, contact: John Jernigan, M.D., 
Centers for Disease Control and Prevention, National Center for 
Infectious Diseases, Division of Healthcare Quality and Promotion, 57 
Executive Park South, Room 4109, Mailstop E-68, Telephone number: 
(404)498-1257, E-mail address: [email protected].

    Dated: May 4, 2002.
Sandra R. Manning,
Director, Procurement and Grants Office, Centers for Disease Control 
and Prevention.
[FR Doc. 02-11709 Filed 5-9-02; 8:45 am]
BILLING CODE 4163-18-P