The Joint Commission (TJC) has released significant updates for 2025 and 2026, including a new chapter on workplace violence prevention and a complete structural overhaul of the safety and environment chapters.
This article serves as a practical guide for nurse managers, distilling the essential information from the dense TJC manuals into the top 5 changes and focus areas you need to know to ensure your unit is survey-ready.
1. The urgent new standard: Workplace Violence Prevention
TJC is now holding organizations 100% accountable for protecting staff from violence, threats, and intimidation from any source (patients, visitors, or staff).
This requirement aligns with the alarming statistic that healthcare workers suffer non-fatal injuries due to violence at rates significantly higher than other professions. In fact, according to the U.S. Bureau of Labor Statistics, healthcare and social assistance workers experienced the highest counts and annualized incidence rates for workplace violence of any private industry sector, accounting for 72.8% of all cases in private industry over the two-year period from 2021-2022.
What the surveyor will ask you
The surveyor will test your system through a realistic scenario: "A nurse was threatened by a patient's family. Walk me through your unit's entire process, from immediate response to post-incident follow-up."
Your action plan for WPV
- Know your role in the risk assessment: You must be able to speak to your unit's specific WPV risks identified in the hospital's hazard analysis (e.g., specific shifts or patient populations with higher incidence).
- Prove your staff are trained: You must ensure 100% of your staff (including agency or other temporary nurses) have completed the hospital's de-escalation training and know the reporting procedure.
- Prove you follow up: You must show the surveyor your process for reporting incidents and, most importantly, the debriefs and follow-ups conducted after an incident to prevent recurrence.
- Participate in the annual review: Be prepared to speak about how your unit provided feedback for the hospital's annual WPV program evaluation. Surveyors want to see that the program isn't just “set it and forget it” but is a living document that improves based on staff feedback and incident data.
2. The big overhaul: Physical Environment (PE)
TJC is retiring the "Environment of Care" (EC) and "Life Safety" (LS) chapters. They are being consolidated into a single, new chapter called "Physical Environment" (PE).
While the name is new, the surveyor's "hallway walk" will be the same. They are still hunting for the same "low-hanging fruit" and easy-to-spot hazards.
What the surveyor will do
The "hallway walk" is a guaranteed part of the survey, checking for immediate fire and life safety hazards.
Your action plan (A 10-minute walkthrough checklist)
- Clutter: Are hallways clear? Nothing should block fire exits, pull stations, or electrical panels.
- Power: Is the crash cart plugged into the red emergency outlet? Are computers on wheels (WOWs) stored in designated alcoves and not parked in the hallway (a fire hazard)?
- Med fridges: Are the temperature logs complete for today, and are the temperatures within the acceptable range? Missing or incomplete logs are an instant finding.
- Eyewash stations: Are they being tested weekly? You must be able to show the most recent dated tag documenting when the test occurred.
- Expired supplies: Is there an expired saline flush or dressing in the back of a supply drawer or on the crash cart? Surveyors will find it.
- Ligature risks: While critical in behavioral health, surveyors are now trained to spot ligature-risk points (e.g., non-breakaway shower heads, call bell cords, open-door hinges) in any area where an at-risk patient might be. Know your unit's risk assessment.
3. National Performance Goals (NPG) replace NPSGs
The "National Patient Safety Goals" (NPSG) chapter is being replaced by a new "National Performance Goals" (NPG) chapter.
The core safety concepts aren't vanishing. Instead, TJC has elevated critical topics like suicide risk reduction and staffing to the level of an NPG.
Your action plan
- Know the NPGs: Be able to speak to how your unit identifies patients, manages alarm fatigue, and prevents suicide, now under the new NPG framework.
- Re-orient staff: Ensure your team knows the NPSGs have been replaced. Update huddle boards or posters that reference the old "NPSGs."
4. The #1 survey focus: Health Equity (LD.04.03.08)
TJC has moved from recommending health equity to requiring it. This is a guaranteed focus area for every surveyor. The expectation is to identify, document, and actively reduce health disparities.
What the surveyor will ask you
"Show me the data for your unit's top health disparity," and "What is your action plan to fix it?"
Your action plan
- Know your data: Be able to pull sociodemographic data (race, ethnicity, language, SOGI).
- Identify a disparity: Work with your quality team to pinpoint one specific disparity. For example, be aware that patients with limited English proficiency (LEP) often experience higher rates of readmission due to communication barriers. Your unit's data should support a finding, such as: "Our Spanish-speaking patients have a 15% higher fall rate."
- Show your work: Have a documented plan to address it.
5. The "Gotcha" standard: Staff competency & agency staffing
Staffing compliance, especially for non-employee staff (travelers, agency, temp, PRN, float pool), is a frequent area of citation. TJC surveyors will always pull the files of your non-employee staff for spot-checks.
What the surveyor will ask you
The question is direct: "You have 3 agency nurses on your unit today. Show me their files. Show me their license, their core competencies, and their unit-specific orientation."
Your action plan for staffing compliance
- The "TJC-ready" file: A missing or expired document (license, BLS/ACLS, or TB status) is an immediate finding. You must have instant digital access to every temporary nurse's complete compliance file, proving their competency is equivalent to your permanent staff.
- The unit-specific orientation checklist: This is the #1 item managers miss. You must have a simple checklist proving that every PRN nurse was oriented to your unit's crash cart, glucometers, EMR, and code/RRT process.
- Prove competency: A key TJC focus is on ongoing education. Be ready to show how you validate that a PRN nurse is competent for their assignment, not just that they have a valid license.
- The modern solution: Don't let staffing be your TJC weak point. A modern staffing partner, like Nursa, ensures nurses are fully vetted, with credentials accessible 24/7 on a digital platform.
From "survey-ready" to "always-ready"
The 2025 Joint Commission standards are complex, but they boil down to three core responsibilities for nurse managers:
- Protecting patients (Equity & safety goals)
- Protecting staff (WPV)
- Proving competence (HR & staffing)
A TJC survey isn't a pop quiz you cram for. By building these 5 points into your daily leadership rounds, you create a culture of "always-ready" compliance.
Nursa's platform gives you on-demand access to a network of fully vetted, TJC-ready professionals.
Sign up with Nursa to staff confidently today.
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