With our move to BPAM we have had a better look at stop times for transfusions. My question is when is the stop time determined? When the blood bag is clamped, or when the saline flush is complete and the tubing is cleared? All my readings have not specified what action constitutes a stop of the transfusion.

My opinion - when the last of the blood is infused.  If that includes the saline flush/tubing cleared, so be it.

Having been out of the loop for awhile, what is BPAM?

As far as stop time, I'm with David, when the last of the blood is infused.  I would assume that the nurse responsible for the transfusion would be the one to determine when that is since they will be the one making that decision.  Also, there are occasions, for one reason or another, the transfusion will be stopped prior to the bag being emptied.  Again, the nurse makes the decision and will be the one documenting the stop time.

Blood Product Administration Module. It's a pretty cool feature in the EMR that has helped tremendously with nursing documentation in our facility.

I agree with both David and John. I have a nurse who is saying that they are having a hard time with the 4 hour transfusion requirement with including the saline flush which seems very odd to me. Thank you for confirming thoughts!

If they are exceeding 4 hours they are running that unit slooooowly. Most of our infusions are complete around the 2 hour mark.

I agree with the above statements.  Our nurses usually get two units infused withing 4 hours so they don't have to use a second blood administration set.

When we started using Epic we had to have the physicians change from ordering the nurse to transfuse over 4 hours to over 3.5 hours or 3 hours 45 minutes because of the way it's documented in the BPAM.  We use the completion of the entire transfusion, blood and saline, as the end of the transfusion.