Purpose: Saint Francis Hospital in Tulsa, Oklahoma currently participates in the National Database of Nursing Quality Indicators (NDNQI) for adult inpatient units. Saint Francis Hospital nursing outcomes for patient falls and hospital acquired pressure ulcers in the adult population have improved, due to the focus placed on nurse sensitive indicators and through our participation in the NDNQI database. However, because there is not a reliable validated tool to predict pediatric patient falls, our pediatric units are unable to reliably benchmark and compare data for pediatric falls. Our purpose was to identify and describe risk factors associated with falls in hospitalized children for the development of a predictive fall risk assessment tool, which would facilitate future data collection and analysis of pediatric falls. Risk factors were identified in Phase I of a nursing research project “Falls in Hospitalized Children,” (Razmus, Wilson, Neuman & Smith,  2006).  Methods: A Fall Risk Assessment tool (CHAMPS) was developed from the data obtained in a study comparing 100 pediatric fallers to 100 pediatric non-fallers, matched for chronological age and year of hospital admission. Results: This pediatric fall risk predictive tool (CHAMPS) was integrated into our computerized nursing documentation system.  Each patient is assessed on admission and every other day while hospitalized.  A change in status or a transfer between units would generate a new fall assessment. The CHAMPS tools includes the significant pediatric risk factors of Change in Mental Status, History of Falling, Age (less than 3 years developmentally or chronologically), and Mobility-alteration. Phase II of this project is in progress with the goal of establishing which risk factors, or combination of risk factors, are more predictive of falls in hospitalized children. Interventions to prevent falls are also being measured for those children identified as high risk for falls in the hospital. Conclusions: A valid and reliable tool to predict pediatric patients at risk for falls, as well as valid and reliable interventions to prevent falls, would decrease costs and consequences associated with an accidental fall in the hospital and provide for better comparison of pediatric fall data between hospitals. Utilizing the information from Phase I of this study, a predictive pediatric fall risk assessment tool (CHAMPS) has been successfully implemented. Currently, our pediatric fall occurrences have decreased with no pediatric falls in the month of September 2006 and we look forward to sustained improvement with continued use of the CHAMPS tool. It is our hope that other pediatric units will learn of the this tool and participate in the validation process. A reliable and validated pediatric fall risk assessment tool would facilitate the development and implementation of pediatric fall indicators for pediatric fall data collection and benchmarking in the future.