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Various codes of practice, guidelines and protocols exist that support the engagement between health professionals and industry. Of importance is how these engagements can be encouraged to support improved patient outcomes. This article reviews the policies that exist from both the perspective of the health professionals and that of industry within the wound-care market space. Health professionals' engagement with wound-care companies in various guises in practice, including advancement of medical technologies; education development; provision on the safe and effective use of products; and true, practical research and evaluations of products. Joint working initiatives do exist between the NHS and industry that are transparent, mutually beneficial, support patient safety, ensure improved patient experience, and drive clinical effectiveness.

Lower-cost ‘generic’ wound dressings are now available in the dressing categories of foams, films, alginates, gels and hydrocolloids. This offers the possibility of achieving significant financial savings while retaining good clinical standards of wound care. To test the potential for cost saving in a typical London teaching hospital, the ActivHeal®> range of dressings was substituted for normal ‘branded’ dressings over a 3-month period, during which dressing cost and clinical effectiveness were assessed. The result was an equivalent yearly cost saving of £55 221 (54%), with retention of performance standards across the dressing range. Two years after the trial, wards in University College London Hospitals NHS Foundation Trust continue to benefit from significant annual cost savings on dressings by using the ActivHeal range of products, while maintaining a high standard of clinical care.

This article analyses the existing evidence surrounding the use of phosphate enemas in practice. Phosphate enemas are routinely used in a variety of clinical areas to relieve constipation or as a diagnostic bowel preparation. Yet, there is increasing uncertainty about both the medication's clinical effectiveness and its safety. There is limited evidence to suggest the product is more effective than other medications in the management of chronic constipation. However, phosphate enemas are an effective preparation for some diagnostic bowel investigations. There are also a variety of infrequently seen, but detrimental, complications specifically associated with the administration of phosphate enemas. The administration of phosphate enemas should be avoided if clients have certain underlying conditions.

The issues surrounding the use of research to inform practice and the potential problems involved in this process have been the subject of debate within nursing for many years. The purchaser/provider relationship has led to an increase in the number of challenges nursing encounters regarding the implementation of research. These challenges and relationships, which will either promote or prevent the implementation of research in nursing practice, are explored using Nolan and Grant's (1993) framework. The analysis concludes that implementation of nursing research needs to be part of the contracting process involving shared dialogue between purchasers and providers. Discussions on clinical effectiveness need to include nursing evidence as part of the health-care contracting process. Professionals involved in contracting require equal knowledge about research and joint professional values in order to support its implementation within contracting appropriately.

In this article the author discusses three main issues in infection control: the development of clinical effectiveness, education and public health. Present day infection control practice is based on principles put forward by Florence Nightingale over 100 years ago. Despite medical advances, hospital-acquired infection remains a major cause of morbidity and mortality. Further research is required to assess how effective present day infection control activities and policies are in reducing the spread of infection. The success of implementing evidence-based practice relies on multidisciplinary, user-friendly educational initiatives. It is imperative that community practitioners are involved in the promotion of infection control. Greater public awareness of infectious agents and the importance of basic hygiene will ensure that infection control cannot remain the exclusive property of hospitals, but must extend to all areas of public health.