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Published on: August 25, 2014
Validation of the General Risk Assessment for Pediatric Inpatient Falls (GRAF-PIF) on Child and Adolescent Inpatient
Nicole M Benson1,2, Boyu Ren1,2, Amin Yakubu1
1McLean Hospital, Belmont, Massachusetts.
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.
Method:
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. We calculated falls per 1,000 patient days and examined different GRAF-PIF cut-offs for changes in positive predictive value (PPV), sensitivity, and specificity.
Results:
Fall rate was 1.10 per 1,000 patient days. The literature-recommended threshold of 2 yielded a sensitivity, specificity, and PPV of 87.5%, 60.3%, and 0.23%, respectively. The highest PPV (8.7%) occurred with a score of 4 but sensitivity was 46.9%.
Conclusion:
The optimum GRAF-PIF threshold considerably overestimated fall risk in this population, limiting clinical utility for nurses. Future research is needed to explore more accurate ways to assess fall risk for children and adolescents on inpatient psychiatry units.
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