Patients in two acute care university hospitals were entered into the study using the following method: twenty patients were selected each day from all floors/units in each hospital until the hospital communities had been surveyed only once. A total of 762 hospital patients were identified for the study, and the history of each patient was then abstracted from their charts. The data were analyzed as an historical cohort study design. The two hospital samples were compared to show the effects of the non-random sampling method using one hospital as a comparison group for the other. Expected associations between nosocomial infection and known risk factors were compared and contrasted between the hospitals using cumulative incidence rates and relative risk ratios. The average length of stay of the group of patients in each hospital was extended from a mean of ten days to a mean of 30 days. The only significant difference between the two hospital cohorts was an age effect. The advantages and disadvantages of this method for selecting a long staying cohort at high risk for nosocomial infection in acute care facilities are detailed.

To be a nurse involves the assumption of ethical responsibility in all areas of practice. Infection control practice is a nursing specialty which exemplifies two ethical issues: the nurse's duty or moral obligation for patient advocacy and the right of patients to safe care. Individual moral responsibility is an important issue for the nurse epidemiologist because epidemiologic fact-finding provides information that may present ethical problems as well as suggest solutions. This paper discusses ethical dilemmas arising in infection control practice, as illustrated by three actual situations.In the course of practice, questions may arise concerning the ethical responsibilities of a nurse epidemiologist to provide facts that may be used in cases of dispute. This discussion shall be limited to institutionally acquired or nosocomial infections.

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