Background: Palliative care (PC) continues to be underutilized in Nigeria, but there is a lack of studies that explore organizational cultural dynamics regarding PC in Nigeria. The study aimed to understand the organizational culture in order to identify organizational enablers and inhibitors of the provision and utilization of PC in a Nigerian context. Methods: Identification of the organizational culture was developed using a qualitative interpretive descriptive design. Cultural enablers and inhibitors were mapped out using semi-structured interviews with 38 participants, consisting of medical staff, patients, and their relatives. Thematic analysis was used to identify and analyze patterns within the collected data. Results: Three themes were identified: cross-departmental collaborative practice, financial support practice, and continuity of care. The findings suggest that fundamental cultural changes, such as a policy for intradepartmental referral practices, telemedicine, and a welfare support system, are typically required as remedies for the failure to use PC in Nigeria and other similar contexts. Conclusions: This study offered a new understanding that not revealing deeper shared assumptions, and a shared way of thinking that underpins the PC practice within an organization, will have a negative bearing on organizational PC outcomes.

Background: Evidence-based practice (EBP) is widely recognised as being relevant in improving nursing care. However, its implementation in nursing practice has been difficult for nurses, particularly in the developing countries. Existing evidence suggests that bureaucracy in organisational governance impacts implementation processes, however, the nature of this effect is not yet explored. Objective: The study examined experiences of nursing staff implementing EBP in a bureaucratic acute care setting in Nigeria.Methods: A qualitative exploratory design was adopted. A purposive sample of 11 ward managers and 12 staff nurses from a large acute care setting in Nigeria participated in the in-depth, face-to-face interviews. Data was analysed using the thematic analysis approach.Results: Four key themes emerged: (1) top down managerial approach; (2) nurse and nurse manager relations; (3) managerial prerogatives; (4) managerial autonomy.Conclusions and implications for practice: The Nigerian bureaucracy limits professional and managerial autonomy that nurses require in driving EBP implementation. Nurse Managers require greater leadership visibility and structural empowerment to create enabling environment for EBP implementation in nursing.