The purpose of the study was to investigate the assumptions that underpin contemporary hospital infection control programs from the perspective of the influence of clinical culture on the integration and ownership of the infection control program. The results of numerous studies have linked low levels of adherence with infection control principles amongst health care providers as the most significant factor contributing to nosocomial infection. Despite early successes in reducing nosocomial infection rates, results derived from current research demonstrate that nosocomial infection has remained a challenge to healthcare providers and patients alike and outbreaks are regularly reported in the infection control literature. Serious economic and social impact has resulted from the increasing levels of antibiotic resistance that have been reported amongst pathogens associated with nosocomial infection. This interpretive study takes an ethnographic approach, using multiple data sources to provide insight into the culture and context of infection control practice drawing upon clinicians' work and the clinician's perspective. There were three approaches to data collection. A postal survey of surgeons was conducted, a group of nurses participated in a quality activity, and a clinical ethnography was conducted in an intensive care unit and an operating theatre complex. Data were analysed in accordance with the qualitative and quantitative approaches to data management. Findings indicate that the clinical culture exerts significant influence over the degree to which the infection control program activities change practice and that rather than imposing the infection control program on the clinical practice setting from outside, sustained practice change is more likely to be achieved if the motivation and impetus for change is culturally based. Moreover surveillance, if it is to influence clinicians and their practice, must provide confidence in its accuracy. It must be meaningful to them and linked to patient care outcomes. Contemporary hospital infection control programs, based on assumptions about a combination of surveillance and control activities have resulted in decreased nosocomial infection rates. However, sustained infection control practice change has not been achieved despite the application of a range of surveillance and control strategies. This research project has utilized an ethnographic approach to provide an emic perspective of infection control practice within a range of practice contexts. The findings from this study are significant within the context of spiraling health costs and increasing antibiotic resistance associated with nosocomial infection.