Validation of the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) on Child and Adolescent…

ObservationalJournal of psychosocial nursing and mental health services· Apr 2026

Validation of the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) on Child and Adolescent Inpatient Psychiatry Units.

Nicole M Benson, Boyu Ren, Amin Yakubu … Alisa B Busch

Pediatric Hospital MedicineObservationalClinical practiceQ2IF 1.1

GRAF-PIF fall-risk cutoff had only 8.7% positive predictive value in psychiatry inpatients

Validation of the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) on Child and Adolescent Inpatient Psychiatry Units.

Nicole M Benson … Alisa B Busch

Journal of psychosocial nursing and mental health services · Apr 2026

Purpose

To examine optimal threshold score on the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) scale for nurse assessment of fall risk on child and adolescent inpatient psychiatry units.

Methods

A retrospective observational study on two child and adolescent inpatient psychiatry units in a large health system was conducted from July 1, 2019, to August 31, 2023.

n = 1,000 patient

Results

only about 1 in 11 flagged as high risk actually fell

PPV at threshold 2

0.23%

PPV at threshold 4

8.7%

More results

Fall rate was 1.10 per 1,000 patient days.

The literature-recommended threshold of 2 yielded a sensitivity, specificity, and positive predictive value of 87.5%, 60.3%, and 0.23%, respectively.

“

Conclusion · 1 of 2

The optimum GRAF-PIF threshold considerably overestimated fall risk in this population, limiting clinical utility for nurses.

Conclusion · 2 of 2

Future research is needed to explore more accurate ways to assess fall risk for children and adolescents on inpatient psychiatry units.

Validation of the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) on Child and Adolescent Inpatient Psychiatry Units.

Validation of the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) on Child and Adolescent Inpatient Psychiatry Units.

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