In today's competitive market infection control teams are under increasing pressure from purchasing authorities to provide hard data on quality issues. The initial aim of this study was to determine whether a modified form of the audit system used to monitor infection control standards in Derbyshire could be used effectively across three district health authorities. Infection control nurses in each of the study districts have different approaches to training with only Stafford using a link nurse system. Our additional aim therefore was to examine the relationship between the knowledge base of nursing staff and their ward audit score, and to determine whether wards with link nurses achieved significantly higher scores. To establish this a questionnaire was devised and completed by three different grades of staff on each ward at the time of the audit. These results were fed back to the wards and to managers by the infection control nurse, and an action plan given with a review date where applicable. Results of the study indicated that the audit tool could be used effectively in any district but would need modifying for psychiatric departments. The value of education in improving standards of infection control was clearly demonstrated. An important finding in Stafford was that wards with link nurses obtained significantly higher scores. The value of using such a clinically based audit will be discussed.