Was ist das eigentlich? Cyberrisiken verständlich erklärt

Es wird viel über Cyberrisiken gesprochen. Oftmals fehlt aber das grundsätzliche Verständnis, was Cyberrisiken überhaupt sind. Ohne diese zu verstehen, lässt sich aber auch kein Versicherungsschutz gestalten.

Beinahe alle Aktivitäten des täglichen Lebens können heute über das Internet abgewickelt werden. Online-Shopping und Online-Banking sind im Alltag angekommen. Diese Entwicklung trifft längst nicht nur auf Privatleute, sondern auch auf Firmen zu. Das Schlagwort Industrie 4.0 verheißt bereits eine zunehmende Vernetzung diverser geschäftlicher Vorgänge über das Internet.

Anbieter von Cyberversicherungen für kleinere und mittelständische Unternehmen (KMU) haben Versicherungen die Erfahrung gemacht, dass trotz dieser eindeutigen Entwicklung Cyberrisiken immer noch unterschätzt werden, da sie als etwas Abstraktes wahrgenommen werden. Für KMU kann dies ein gefährlicher Trugschluss sein, da gerade hier Cyberattacken existenzbedrohende Ausmaße annehmen können. So wird noch häufig gefragt, was Cyberrisiken eigentlich sind. Diese Frage ist mehr als verständlich, denn ohne (Cyber-)Risiken bestünde auch kein Bedarf für eine (Cyber-)Versicherung.

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ABNN SCRN : Stroke Certified Registered Nurse (SCRN) test MCQs and Practice Test

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Exam Number : ABNN-SCRN
Exam Name : Stroke Certified Registered Nurse (SCRN)
Vendor Name : ABNN
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ABNN-SCRN test Format | ABNN-SCRN Course Contents | ABNN-SCRN Course Outline | ABNN-SCRN test Syllabus | ABNN-SCRN test Objectives


- Anatomy- Physiology- and Pathophysiology of Stroke
- Vascular Anatomy
- Brain Structure
- Stroke Types
- Stroke Syndromes
- Associated Stroke Disorders
- etiology
- Stroke Mimics
- Neuroplasticity
- Cellular Composition and Changes
- penumbra

- Hyperacute Care
- Initial triage
- Assessments
- Diagnostic Tests
- Treatment Considerations
- Thrombolytic Therapy
- Hemorrhagic Interventions
- Ischemic Interventions
- Advanced Interventions
- thrombectomy
- surgical
- Complication Management and Education
- Medications
- Quality Stroke Metrics
- door to needle
- Patient Disposition

- Assessment and Diagnostic Tests
- Hemorrhagic Interventions
- Ischemic Interventions
- Complication Management
- Multidisciplinary Plan of Care
- Safety Measures
- Individualized Care for Activities of Daily Living
- Therapeutic Environment
- sensory
- positioning
- Psychosocial Care
- Education
- Quality Stroke Metrics
- Medications
- Early Rehabilitation and Discharge Planning

- Multidisciplinary Plan of Care
- Goals of Rehabilitation
- Levels of Rehabilitative Care
- Rehabilitation Considerations
- spasticity
- safety
- Stroke Education
- Medication Management
- Community Resources
- support groups

- Primary and Secondary Preventative Care
- Comorbidities and Stroke Risk Factors
- Prevention Measures and Social Determinants of Health
- Diagnostic Tests
- imaging
- lab work
- Medication Education and Management
- Quality Stroke Metrics
- patient education
- Community Health Education

- Correlate deficits or expected complications to site of injury
- Identify physiologic changes at the cellular level
- penumbra
- Identify stroke signs and symptoms
- typical
- atypical
- Recognize stroke syndromes
- Middle Cerebral Artery Syndrome
- Horner's Syndrome
- Wallenberg Syndrome

- Identify underlying etiology of stroke
- Identify stroke mimics
- Differentiate between stroke types
- ischemic
- hemorrhagic
- transient ischemic attack
- Collaborate with multidisciplinary team
- Assess ABCs
- Establish chief complaint
- Identify appropriate level of care
- stroke unit
- certified stroke center
- Stabilize patients for admission or transfer
- Activate an emergency stroke response
- EMS
- Rapid Response
- Code Stroke
- Implement door to treatment times
- protocol and pathways
- Collect focused medical history
- Correlate chief complaint with patient's history and signs/symptoms
- Facilitate diagnostic tests according to clinical practice guidelines
- imaging
- lab work
- Conduct neurological exams
- NIHSS
- GCS
- patient baseline
- Differentiate between expected neurological test findings and emergent concerns
- Prioritize patient's needs based on comprehensive and focused exams
- Hunt & Hess scale
- ICH score
- modified rankin scale
- Assess- monitor- communicate- treat- and document vital signs and pain
- Assess- monitor- communicate- treat- and document oxygenation and ventilation
- Assess- monitor- communicate- treat- and document hydration
- IV solutions
- oral fluid intake
- Assess- monitor- communicate- treat- and document cardiac rate and rhythm
- Assess- monitor- communicate- treat- and document blood glucose
- Assess- monitor- communicate- treat- and document intracranial pressure
- Identify indications and facilitate advanced interventions for ischemic strokes
- thrombolytics
- mechanical embolectomy
- intra-arterial thrombolysis
- hemicraniectomy

- Identify indications and facilitate advanced interventions for subarachnoid hemorrhage
- aneurysm clipping or coiling
- external ventricular drain placement
- Identify indications and facilitate advanced interventions for intracerebral hemorrhagic strokes
- surgical interventions
- Identify indications and facilitate interventions for treatment of cerebral vasospasm
- Calculate- administer- monitor- communicate- and document medications
- Identify inclusion and exclusion criteria for thrombolytic therapy per clinical practice guidelines
- Facilitate administration of thrombolytic therapy
- Manage and assess patient post-thrombolytic administration (expected vs adverse outcomes) per clinical practice guidelines
- Recognize signs of reperfusion syndrome and anticipate potential interventions
- Assess arterial access site and distal extremity post-neurointerventional radiology procedure
- Identify complications of neurointerventional radiology procedures
- hematoma
- arterial dissection
- arterial thrombosis
- pseudo-aneurysms
- bleeding

- Correct coagulopathy including use of reversal agents for anticoagulants
- Identify and manage carotid vascular abnormalities
- Monitor patient safety before- during- and after procedures
- Identify indications and post-procedural care for external ventricular drain
- Identify indications and post-operative care for surgical interventions
- decompression
- carotid endarterectomy
- Implement safety measures
- infection prevention
- fall or seizure precautions
- Assess swallowing ability- including risk of aspiration- and implement precautions
- Implement venous thromboembolism prophylaxis as indicated
- Facilitate compliance with stroke program quality indicators
- door-to-needle
- VTE prophylaxis
- Participate in quality improvement projects
- Provide nursing interventions to address activities of daily living
- early mobilization
- range of motion
- elimination

- Identify- manage- and support rehabilitation needs and goals
- spasticity
- cognition
- psychosocial
- dysphagia
- Provide a therapeutic- patient-centered environment to accommodate for patient deficits and needs
- Assess for and provide patient-centered- inclusive- and culturally sensitive care
- Facilitate care goals such as discharge planning- palliative care- and end-of-life care

- Collaborate with care team on nutritional needs
- specialty diets
- fluid consistency
- alternate forms of nutrition
- Create and maintain a patient-centered and multidisciplinary plan of care
- Facilitate the discharge planning process
- Incorporate patient-specific transfer techniques and assistive devices
- Identify and educate on patient-specific comorbidities and stroke risk factors
- Assess family and/or caregiver dynamics as it impacts care outcomes
- Recognize psychosocial impact of stroke on patient outcomes
- poststroke depression

- Assess barriers and social determinants of health as it impacts care
- Support the spiritual/emotional needs of patient- family- and caregivers
- Provide and reinforce stroke education to patients- family- and caregivers- including risk factors- symptoms- and activation of EMS
- Provide education on primary and secondary preventions and the importance of provider follow-up
- Provide education about medications and medication management to patients- family- and caregivers
- Provide stroke education to the community including community outreach programs
- Identify patient-centered community resources
- support groups
- financial support
- Collaborate with care team for patient referrals



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Warum sind Cyberrisiken so schwer greifbar?

Als mehr oder weniger neuartiges Phänomen stellen Cyberrisiken Unternehmen und Versicherer vor besondere Herausforderungen. Nicht nur die neuen Schadenszenarien sind abstrakter oder noch nicht bekannt. Häufig sind immaterielle Werte durch Cyberrisiken in Gefahr. Diese wertvollen Vermögensgegenstände sind schwer bewertbar.

Obwohl die Gefahr durchaus wahrgenommen wird, unterschätzen viele Firmen ihr eigenes Risiko. Dies liegt unter anderem auch an den Veröffentlichungen zu Cyberrisiken. In der Presse finden sich unzählige Berichte von Cyberattacken auf namhafte und große Unternehmen. Den Weg in die Presse finden eben nur die spektakulären Fälle. Die dort genannten Schadenszenarien werden dann für das eigene Unternehmen als unrealistisch eingestuft. Die für die KMU nicht minder gefährlichen Cyber­attacken werden nur selten publiziert.

Aufgrund der fehlenden öffentlichen Meldungen von Sicherheitsvorfällen an Sicherheitsbehörden und wegen der fehlenden Presseberichte fällt es schwer, Fakten und Zahlen zur Risikolage zu erheben. Aber ohne diese Grundlage fällt es schwer, in entsprechende Sicherheitsmaßnahmen zu investieren.

Erklärungsleitfaden anhand eines Ursache-Wirkungs-Modells

Häufig nähert man sich dem Thema Cyberrisiko anlass- oder eventbezogen, also wenn sich neue Schaden­szenarien wie die weltweite WannaCry-Attacke entwickeln. Häufig wird auch akteursgebunden beleuchtet, wer Angreifer oder Opfer sein kann. Dadurch begrenzt man sich bei dem Thema häufig zu sehr nur auf die Cyberkriminalität. Um dem Thema Cyberrisiko jedoch gerecht zu werden, müssen auch weitere Ursachen hinzugezogen werden.

Mit einer Kategorisierung kann das Thema ganzheitlich und nachvollziehbar strukturiert werden. Ebenso hilft eine solche Kategorisierung dabei, eine Abgrenzung vorzunehmen, für welche Gefahren Versicherungsschutz über eine etwaige Cyberversicherung besteht und für welche nicht.

Die Ursachen sind dabei die Risiken, während finanzielle bzw. nicht finanzielle Verluste die Wirkungen sind. Cyberrisiken werden demnach in zwei Hauptursachen eingeteilt. Auf der einen Seite sind die nicht kriminellen Ursachen und auf der anderen Seite die kriminellen Ursachen zu nennen. Beide Ursachen können dabei in drei Untergruppen unterteilt werden.

Nicht kriminelle Ursachen

Höhere Gewalt

Häufig hat man bei dem Thema Cyberrisiko nur die kriminellen Ursachen vor Augen. Aber auch höhere Gewalt kann zu einem empfindlichen Datenverlust führen oder zumindest die Verfügbarkeit von Daten einschränken, indem Rechenzentren durch Naturkatastrophen wie beispielsweise Überschwemmungen oder Erdbeben zerstört werden. Ebenso sind Stromausfälle denkbar.

Menschliches Versagen/Fehlverhalten

Als Cyberrisiken sind auch unbeabsichtigtes und menschliches Fehlverhalten denkbar. Hierunter könnte das versehentliche Veröffentlichen von sensiblen Informationen fallen. Möglich sind eine falsche Adressierung, Wahl einer falschen Faxnummer oder das Hochladen sensibler Daten auf einen öffentlichen Bereich der Homepage.

Technisches Versagen

Auch Hardwaredefekte können zu einem herben Datenverlust führen. Neben einem Überhitzen von Rechnern sind Kurzschlüsse in Systemtechnik oder sogenannte Headcrashes von Festplatten denkbare Szenarien.

Kriminelle Ursachen

Hackerangriffe

Hackerangriffe oder Cyberattacken sind in der Regel die Szenarien, die die Presse dominieren. Häufig wird von spektakulären Datendiebstählen auf große Firmen oder von weltweiten Angriffen mit sogenannten Kryptotrojanern berichtet. Opfer kann am Ende aber jeder werden. Ziele, Methoden und auch das Interesse sind vielfältig. Neben dem finanziellen Interesse können Hackerangriffe auch zur Spionage oder Sabotage eingesetzt werden. Mögliche Hackermethoden sind unter anderem: Social Engineering, Trojaner, DoS-Attacken oder Viren.

Physischer Angriff

Die Zielsetzung eines physischen Angriffs ist ähnlich dem eines Hacker­angriffs. Dabei wird nicht auf die Tools eines Hackerangriffs zurückgegriffen, sondern durch das physische Eindringen in Unternehmensgebäude das Ziel erreicht. Häufig sind es Mitarbeiter, die vertrauliche Informationen stehlen, da sie bereits den notwendigen Zugang zu den Daten besitzen.

Erpressung

Obwohl die Erpressung aufgrund der eingesetzten Methoden auch als Hacker­angriff gewertet werden könnte, ergibt eine Differenzierung Sinn. Erpressungsfälle durch Kryptotrojaner sind eines der häufigsten Schadenszenarien für kleinere und mittelständische Unternehmen. Außerdem sind auch Erpressungsfälle denkbar, bei denen sensible Daten gestohlen wurden und ein Lösegeld gefordert wird, damit sie nicht veröffentlicht oder weiterverkauft werden.

Ihre Cyberversicherung sollte zumindet folgende Schäden abdecken:

Cyber-Kosten:

  • Soforthilfe und Forensik-Kosten (Kosten der Ursachenermittlung, Benachrichtigungskosten und Callcenter-Leistung)
  • Krisenkommunikation / PR-Maßnahmen
  • Systemverbesserungen nach einer Cyber-Attacke
  • Aufwendungen vor Eintritt des Versicherungsfalls

Cyber-Drittschäden (Haftpflicht):

  • Befriedigung oder Abwehr von Ansprüchen Dritter
  • Rechtswidrige elektronische Kommunikation
  • Ansprüche der E-Payment-Serviceprovider
  • Vertragsstrafe wegen der Verletzung von Geheimhaltungspflichten und Datenschutzvereinbarungen
  • Vertragliche Schadenersatzansprüche
  • Vertragliche Haftpflicht bei Datenverarbeitung durch Dritte
  • Rechtsverteidigungskosten

Cyber-Eigenschäden:

  • Betriebsunterbrechung
  • Betriebsunterbrechung durch Ausfall von Dienstleister (optional)
  • Mehrkosten
  • Wiederherstellung von Daten (auch Entfernen der Schadsoftware)
  • Cyber-Diebstahl: elektronischer Zahlungsverkehr, fehlerhafter Versand von Waren, Telefon-Mehrkosten/erhöhte Nutzungsentgelte
  • Cyber-Erpressung
  • Entschädigung mit Strafcharakter/Bußgeld
  • Ersatz-IT-Hardware
  • Cyber-Betrug