Nurses have long been advocates of improved nurse staffing and nurse-patient ratios. In a momentous step towards increased patient safety and nurse staffing, The Joint Commission (TJC) has included nurse staffing in its National Performance Goals for 2026.
The goal states, "The hospital is staffed to meet the needs of the patients it serves, and staff are competent to provide safe, quality care." This will not only improve nurse staffing but also ensure that hospitals are staffed with well-trained and competent individuals to protect patient safety.
Dangers of Nursing Staff Shortages
Inadequate nurse staffing poses significant dangers and risks to patient care and nurse retention, which is directly tied to patient safety. High nurse-patient ratios have been shown to have negative consequences for patients and healthcare workers. Nurse understaffing and high patient loads lead to decreased patient monitoring and quality of care. Additionally, high nurse burnout rates cause nurses to leave the profession, contributing to a vicious cycle that jeopardizes patient safety.
Dangers include:
- Missed tasks (such as missing time-sensitive mediations or procedures)
- Increased patient mortality rates
- Increased patient morbidity rates
- Increased errors
- Nurse burnout and job dissatisfaction
- Nurses feel they cannot adequately care for the patients assigned
- Higher failure-to-rescue rates
- Increased hospital costs as a result of inefficient and inadequate patient care
Such dangers and consequences are means for requiring improved staffing numbers, ratios, and quality nurse training.
Causes of Nursing Staff Shortages
Nursing shortages can be the result of multiple variables, often that further compound one another. Many of these factors can be addressed on a hospital level, emphasizing the importance of TJC's new performance goal pertaining to nurse staffing.
Nursing staff shortages can be due to:
- Lack of potential educators
- High turnover and nurse burnout
- Stressful work conditions
- Inequitable workforce distribution
- Aging workforce
- Career and family
- Healthcare violence
- Budget restrictions
- Inappropriate personnel deciding staffing numbers and ratios
The Joint Commission
To better understand the significance of this recent step towards improved staffing, it is important to understand the organization behind the new goal. So, what is TJC, and what impact does it have?
TJC is a not-for-profit organization that accredits and evaluates United States Healthcare programs and organizations and is focused on patient safety. Typically, healthcare organizations and hospitals are accredited every 2-3 years, in which they are required to demonstrate adherence to specific policies and procedures.
Accreditation shows that the organization prioritizes patient safety and is compliant with patient safety goals. Lack of adherence leads to accreditation denials and reimbursement rejections. With 20,000 healthcare programs and organizations under the accreditation of TJC, it can have a major impact on the implementation of patient safety standards, including nurse staffing.
The Joint Commission National Performance Goal 12
TJC released the National Performance Goals Effective January 2026 for the Hospital Program, which will take effect on January 1, 2026. The issue of nurse staffing is addressed in the National Performance Goal (NPG) 12, which is a major step towards improving nurse staffing. What exactly does this goal entail?
This goal requires that not only must there be enough nurses to appropriately care for the patients within the hospital organization, but nurses must be competent and trained to provide exceptional patient care. TJC goal 12 specifies, "Adequacy of staffing includes the number, skill mix, and competency of all staff", and "Leaders provide for an adequate number and mix of qualified individuals to support safe, quality care, treatment, and services."
It also recommends examining assessment, credentialing, supervision of staff, training, and education of staff members. Additionally, healthcare organizations must have a nurse on duty whenever Critical Access Hospitals have one or more inpatients.
This staffing goal is not limited to nurses alone, but pertains to those who specialize in other areas of patient care, such as:
- Rehabilitation services
- Emergency services
- Respiratory services
- Outpatient services
- Pharmaceutical services
- Diagnostic and therapeutic radiology services
- Dietetic services
- Medical record services
- Infection prevention
This goal also includes assigning a nurse who is responsible for the operation of nursing services, such as policies and procedures, and determining the types and numbers of individuals, including nurses, to provide nursing care. It reads, "There are supervisors and staff for each department or nursing unit to make certain a registered nurse is immediately available for the care of any patient." Adequately staffing all aspects of patient care leads to improved diagnostic abilities, treatment, thorough monitoring, and overall patient safety.
Benefits of Improved Nurse Staffing
Improved nurse staffing leads directly to improved patient safety and improved nurse wellbeing. 87% of nurses reported that improving nurse staffing was very important to mental health and well-being. 45% of physicians, who rely on nurses, say improving nurse staffing is very important.
Benefits include:
- Reduced adverse patient outcomes
- Decreased errors
- Decreased nurse burnout and stressful work conditions
- Preventing missed nursing care due to inadequate patient surveillance
- Decreased chances of delayed or omission of care
- Improved nurse job satisfaction and nurse retention
One of the bottlenecks of determining staffing numbers is having individuals who do not work directly at the bedside or on the unit determine nurse-patient ratios. Allowing bedside nurses to determine acceptable nurse-patient ratios, rather than an administrator or manager, will lead to improved nursing job satisfaction, less burnout, and improved patient safety, which is supported by the recent goal from TJC. Enhanced nurse staffing improves the experience and safety of both patients and staff members involved in direct patient care.
Conclusion
The recent release ofThe Joint Commission's National Performance Goals, Effective January 2026, for the Hospital Programand its inclusion of focusing on adequate nurse staffing has many nurses excited and hopeful for improved patient safety and personal well-being.The focus of this goal is on ensuring an adequate number of nurses to support patient care, as well as requiring that those staff members be trained and able to address the specific medical needs of the patients. Improving nurse staffing will set a course for safer treatment conditions and nurse retention, both of which set the stage for a future of improved medical care.
About the Author:
Rachel Pugmire is a registered nurse and freelance writer. She received her Bachelor of Science in Nursing in 2018, with a minor in gerontology. Her areas of expertise include emergency medicine, pediatrics, and pharmaceutical clinical trials. Medical writing has given her a platform to do what she is passionate about, which is educating patients, their families, and other healthcare professionals.
Rachel is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely those of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfast's Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
