I work in an outpatient clinic which is attached to our hospital where we do numerous OP infusions with the exception of chemotherapy. We see patients from different providers throughout our area. One situation we recently experienced was a provider sent an order for 2 units PRBC with an H&H that was obtained 11 days prior. As a department we questioned if this is best practice and did communicate to the provider that we would like to draw an H&H prior to the transfusion to know where the patient's levels were to date. The provider had no problem with this order but we wanted to get some protocols in place as we felt a little uneasy about giving blood based off "old labs." I have combed through my facilities P&P, looked through INS SOP, contacted blood bank, and spoke to our pathologist and have not found or received any guidance about how old is too old regarding an H&H when it is being used to diagnose the need for a blood transfusion. Does anyone know of any literature stating what the "best practice" is concerning a transfusion and the related H&H?