Date of Conferral



Doctor of Nursing Practice (DNP)




Marilyn Murphy


Length of hospital stay (LOS) is a major indicator for measuring efficient care. Intellectually disabled psychiatric patients (IDPP) with chronic medical problems have longer LOS due to challenges faced by providers in jointly managing both psychiatric and medical problems. The purposes of this study were to understand the significance of LOS for IDPP, create an intervention toolkit to reduce LOS, establish the content validity of the toolkit, and recommend its implementation. The items of the toolkit are pharmacology, somatic, rehabilitation, psychosocial, and monitoring patients' psychiatric and medical symptoms across care domains. The toolkit was created from the constructs of the psychiatric rehabilitation process model to jointly mange psychiatric and medical issues. The project question asked if a universal agreement rating will be achieved to establish content validity of the toolkit. Orem's self-care deficit theory was used to guide this study. Ten experts with experience in the clinical, financial, legal, and psycho-social aspects of IDPP care, were recruited from 5 county facilities and asked to participate in the study. The inclusion criteria focused on the experts' leadership roles in those facilities. The experts answered two online quantitative surveys. Survey 1 asked 9 questions and elicited opinions on LOS issues for IDPP. Survey 2 asked the experts to rate the efficacy of the toolkit to reduce LOS for IDPP. Survey 1 finding showed that 8 of 10 experts agreed that LOS for IDPP needed to be reduced. Survey 2 finding showed a universal agreement toolkit rating of 0.84, indicating the experts' readiness to adopt the toolkit to reduce LOS for IDPP. This study has the potential to promote social change by enhancing interdisciplinary and collaborative use of best care processes in psychiatry to reduce LOS and jointly manage psychiatric and medical problems affecting IDPP.