Roles of those involved with wound care in Tshwane District’s residential aged care facilities: findings from a stakeholder analysis

Background: Older people are at an increased risk for wounds and require an evidence-based, interprofessional approach. This paper reports on a stakeholder analysis that aimed to identify the stakeholders important to implementing evidence-based wound care in residential aged care facilities (RACF) in the Tshwane District, based on their levels of involvement in wound care and organisational change processes, and to explore their roles. Methods: A multimethod design was used. Quantitative data (a score rating importance) were collected through structured interviews with 14 nurse managers at 14 RACFs from lower-, middle-, and higher-income areas. An open-ended interview question explored stakeholder roles in wound care and organisational change processes. Qualitative data were analysed using both deductive and inductive approaches. Results: Twenty-six stakeholder types were identified. The nurse manager was perceived as the most important stakeholder in establishing evidence-based wound care, followed by wound care practitioners, general practitioners, administrative managers, nursing staff, care workers, residents and their families, pharmaceutical company representatives, social workers, physiotherapists, occupational therapists, dietitians, and a few external organisations. Stakeholders contributed directly and indirectly to wound care, education, and change implementation. Conclusion: The nurse manager emerged as a central coordinating figure in wound care and change processes within RACFs. However, resource constraints limited access to qualified wound care practitioners and other professionals needed for managing complex wounds in older people. Stakeholder engagement for establishing evidence-based wound care should be responsive to each RACF’s unique staffing and organisational structures.