Dr Rachel Evley qualified as a Registered Nurse in 1995 from Sheffield University and after a brief period at the Derbyshire Royal Infirmary working in Trauma & Orthopaedics moved to Nottingham University Hospitals NHS Trust in 1998 to the Adult Intensive Care Unit. In 2001 Dr Evley took up the post of Research Nurse on the Adult Intensive Care Unit and in 2004 relocated to the Anaesthesia & Intensive Care Research Group to further develop her Research Nurse role.
In 2008-2009 Rachel was seconded to the Royal College of Anaesthetists & the National Patient Safety Agency investigating the feasibility of introducing double checking into anaesthetic practice. During this time commencing her PhD investigating safety in anaesthesia and the role systems, technology and culture play.
Currently Rachel is providing research expertise to the Royal College of Anaesthetists for the process of updating 'Guidelines for the Provision of Anaesthesia Services' so that they fulfil the standard criteria for accreditation by the National Institute for Health and Care Excellence (NICE), http://www.rcoa.ac.uk/news-and-bulletin/rcoa-news-and-statements/royal-college-of-anaesthetists-awarded-nice-accreditation
Rachel currently teaches qualitative observational research methods on the N-TRANS course; School of Medicine, and is joint module conveyer for Research and Improvement Project Methodology with the Quality and Patient Safety Improvement (QPSI) Msc; School of Health Sciences
Rachel is also a Senior Advisor in Qualitative Methodology for the NIHR East Midlands Research Design Service
Rachel supervises students up to PhD level within the Anaesthesia & Intensive Care Research Group.
Qualitative Research Methodology
- Grounded Theory
- Delphi Methodology
Qualitative Research Methods
- Participant and non-participant Observation
- Focus Groups
- On line Surveys
Narrative Systematic Reviews
- Patient Safety Research
- Anaesthesia & Intensive Care research
- Perioperative Medicine
- Management of local, national & international research studies
- Protocol Development
- HRA applications
- Grant Applications
- British Journal of Anaesthesia
- BMJ Open
- National Institute of Academic Anaesthesia
Membership of Professional Groups
- Safe Anaesthesia Liaison Group
I am the author & convenor of the Qualitative Observational Studies module within the Nottingham Translational Research (N-Trans) Training Programme; Faculty of Medicine and Health Sciences,… read more
Drug Error and Medication Safety
In 2008 I was seconded to work with the National Patient Safety Agency (NPSA) and the Royal College of Anaesthetists looking at the feasibility of introducing double checking into anaesthetic practice for the preparation and delivery of intravenous drugs. This study led to greater awareness of drug errors within the UK anaesthetic community. This work has been published in the British Journal of Anaesthesia and a Final report was published by the National Patient Safety Agency.
In 2009 I collaborated with Professor Alan Merry from the University of Auckland, New Zealand, managing the UK arm of an international study exploring workload, drug preparation and drug error. This also involved ensuring three high-fidelity simulations of surgery and anaesthesia were accurately recreated from the New Zealand model. The research paper has been published in Anesthesiology
More recently in 2017 we explored the potential safety impact of using a simple colour-coded tray for anaesthetic drug preparation and storage. We found that using standard, single compartment trays enabled quick, cheap, and portable drug preparation and storage, but was linked to potential or actual harmful errors, such as syringe swaps. Rainbow trays were perceived to be easy to use and effective at all three sites, aiding drug identification and separation, and hence likely to reduce drug error and increase patient safety. We demonstrated that it is feasible to introduce a new colour-coded compartmentalised Rainbow drugs tray into clinical practice at three NHS hospitals in England. This work has been published in Anaesthesia
Postoperative Respiratory Rate Abnormalities
International Delphi study to explore postoperative respiratory complications, including the barriers and facilitators to utilising continuous respiratory rate monitoring in the post-operative period. I collaborated with Professor Albert Dahan on an International multi-centre qualitative observation study investigating the incidence of postoperative respiratory rate abnormalities and the use of a continuous respiratory rate monitor. This was a novel study and clinically highly relevant as early warning systems within the NHS utilise respiratory rate monitoring as a key indicator of patient deterioration.
Currently there is little research into what General Practitioners consider to be good post-surgical outcomes. This Delphi study involving 20 General Practitioners aimed to capture the knowledge and wealth of experience in the Primary Care setting, to understand what the key concerns patients present to their General Practitioner, and to define the key measures which General Practitioners would consider important in determining a good outcome following surgery.
Systematic Narrative Reviews
I currently provide methodology expertise to the Royal College of Anaesthetists to support National Institute for Health and Care Excellence (NICE) accreditation for the Guidelines for the Provision of Anaesthesia Services (GPAS) document. We have nearly completed all of the 16 chapters and all chapters using the new process have gained NICE accreditation using the new rigorous evidence-based process, developed by myself and colleagues, which involves a variety of stakeholders and several stages of peer review.
The Impact on health care policy is significant, this document is used for benchmarking and all NHS Hospital Trusts will be judged against the key recommendations for Anaesthesia Clinical Services Accreditation.
ALMGHAIRBI DS, SHARP L, GRIFFITHS R, EVLEY R, GUPTA S and MOPPETT IK, 2018. An observational feasibility study of a new anaesthesia drug storage tray. Anaesthesia. 73(3), 356-364 BROENS SJ, HE X, EVLEY R, OLOFSEN E, NIESTERS M, MAHAJAN RP, DAHAN A and VAN VELZEN M, 2017. Frequent respiratory events in postoperative patients aged 60 years and above. Therapeutics and clinical risk management. 13, 1091-1098 MERRY AF, HANNAM JA, WEBSTER CS, EDWARDS KE, TORRIE J, FRAMPTON C, WHEELER DW, GUPTA AK, MAHAJAN RP, EVLEY R and WELLER JM, 2017. Retesting the Hypothesis of a Clinical Randomized Controlled Trial in a Simulation Environment to Validate Anesthesia Simulation in Error Research (the VASER Study). Anesthesiology. 126(3), 472-481
MOPPETT, I. K., ROWLANDS, M., MANNINGS, A., MORAN, C. G. and WILES, M. D., 2015. LiDCO-based fluid management in patients undergoing hip fracture surgery under spinal anaesthesia: a randomized trial and systematic review BRITISH JOURNAL OF ANAESTHESIA. 114(3), 444-459
I am the author & convenor of the Qualitative Observational Studies module within the Nottingham Translational Research (N-Trans) Training Programme; Faculty of Medicine and Health Sciences, University of Nottingham.
I am the joint module lead and lecturer for Research and Improvement Project Methodology within the MSC Quality & Patient Safety Improvement; Faculty of Medicine and Health Sciences, University of Nottingham.
I am the author of the qualitative research module for anaesthesia e-Learning for Healthcare. My learning session covers the knowledge and key concepts of qualitative research methodology supporting the anaesthetic curriculum and assisting trainees in preparing for the Fellowship of the Royal College of Anaesthetists (FRCA) examination. e-learning for Healthcare is a Health Education England Programme in partnership with the NHS and Professional Bodies
I instruct and support undergraduate and postgraduate students, NHS Doctors and Allied Health Professions in translation research skills:
- Processes for gaining ethical and governance approval for Phase I to Phase IV clinical studies and qualitative research projects
- Screening, recruiting and consenting participants into research studies
- Practical skills associated with different qualitative and quantitative methodology including specialist equipment training
- Qualitative Data analysis utilising NVivo
Distractions in Anaesthesia and Critical Care
Distractions are cited as contributory to healthcare associated errors in a large proportion of incidents. We have carried out observation studies within anaesthesia and critical care to investigate the level of distraction experienced by anaesthetists and critical care teams.
This work was published in British Journal of Anaesthesia
Critical Care Research
I have carried out a number research studies within Critical Care utilising qualitative methodology to explore beliefs, knowledge, barriers and facilitators in the topics of restraint, anxiety, agitation and handover