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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Exam Number : CCRN-Adult
Exam Name : Critical Care Register Nurse - Adult
Vendor Name : AACN
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CCRN-Adult exam Format | CCRN-Adult Course Contents | CCRN-Adult Course Outline | CCRN-Adult exam Syllabus | CCRN-Adult exam Objectives


Exam Code: CCRN-Adult
Exam Name: Critical Care Register Nurse - Adult
Total Questions: 150 multiple-choice questions.
Scored Questions: 125 questions are scored- 25 questions are unscored.
Time Allotted: 3 hours.
Passing Score: A minimum of 83 correct answers out of the 125 scored questions is required to pass.

- Cardiovascular
- Acute coronary syndrome
- Aortic aneurysm- dissection- rupture (i.e.thoracic- abdominal)
- Cardiac infection and inflammatory diseases
- Cardiac surgery
- Cardiac tamponade
- Cardiac trauma
- Cardiac/vascular catheterization
- Cardiogenic shock
- Cardiomyopathy
- Dysrhythmias
- Heart failure
- Hypertensive crisis
- Myocardial conduction system defects (e.g.-prolonged QT interval- Wolff-Parkinson-White)
- Structural heart defects (acquired andcongenital- including valvular disease)
- Vascular disorders (e.g.- arterial/venousstenosis)
- Vascular interventions (e.g.- stents- fem-pop bypass- carotid endarterectomy)
- Respiratory
- Acute pulmonary edema
- Acute pulmonary embolus
- Acute respiratory distress syndrome (ARDS)
- Acute respiratory failure
- Acute respiratory infection (e.g.- pneumonia)
- Chronic conditions (e.g.- COPD- asthma-bronchitis- emphysema)
- Mechanical ventilation complications
- Pleural space abnormalities(e.g.- pneumothorax- hemothorax- empyema-pleural effusions)
- Pulmonary hemorrhage
- Pulmonary hypertension
- Status asthmaticus
- Thoracic and airway trauma (e.g.- fractured rib-lung contusion- tracheal perforation)
- Thoracic surgery
Endocrine- Hematology/Immunology- GI- Renal/GU- Integumentary (21%)
- Endocrine
- Adrenal insufficiency
- Diabetes insipidus (DI)
- Diabetes mellitus- types 1 and 2
- Diabetic ketoacidosis (DKA)
- Hyperglycemia
- Hyperosmolar hyperglycemic state (HHS)
- Syndrome of inappropriate of antidiuretichormone secretion (SIADH)
- Thyroid disorders
- Hematology and Immunology
- Anemia
- Autoimmune disorders (e.g.- lupus-myasthenia gravis- Guillain-Barrésyndrome)
- Coagulopathies (e.g.- ITP- DIC- HIT)
- Myelosuppression (e.g.- thrombocytopenia-neutropenia)
- Oncologic complications (e.g.- tumor lysissyndrome- neutropenia)
- Transfusion reactions (e.g.- TRALI- TACO)
- Gastrointestinal
- Abdominal compartment syndrome
- Acute abdominal trauma
- Acute GI hemorrhage
- Bowel infarction- obstruction- perforation(e.g.- mesenteric ischemia- adhesions)
- GI surgeries (e.g.- Whipple- esophagectomy-resections)
- Hepatic failure/coma (e.g.- portalhypertension- cirrhosis- esophageal varices-fulminant hepatitis- biliary atresia)
- Liver disease
- Malnutrition and malabsorption
- Pancreatitis
- Peritonitis
- Renal and Genitourinary
- Acute kidney injury (AKI)- acute tubular necrosis (ATN)
- Chronic kidney disease (CKD)
- Infections (e.g.- kidney- urosepsis)
- Endocrine- Hematology/Immunology- GI- Renal
- Integumentary
- Cellulitis
- IV infiltration
- Necrotizing fasciitis
- Pressure injury
- Skin failure (e.g.- perfusion injuries)
- Wounds
Musculoskeletal- Neurological- Behavioral/Psychosocial
- Musculoskeletal
- Compartment syndrome
- Fractures
- Muscular deconditioning
- Musculoskeletal trauma
- Neurological
- Acute spinal cord injury
- Brain death
- Encephalopathy
- Stroke (e.g.- hemorrhagic- ischemic)
- Hydrocephalus
- Neurogenic shock
- Neurologic infectious disease (e.g.- viral-bacterial- fungal)
- Neurological storming
- Neuromuscular disorders (e.g.- ALS-neuromyopathies)
- Neurosurgery
- Neurovascular abnormalities
- Seizure disorders
- Space-occupying lesions (e.g.- braintumors- cysts)
- Spinal surgeries
- Traumatic brain injury (e.g.- epidural-subdural- concussion- non-accidentaltrauma)
- Behavioral and Psychosocial
- Agitation
- Anti-social behaviors- aggression- violence
- Delirium
- Medical non-adherence
- Mood disorders- depression- anxiety
- Post-intensive care syndrome (PICS)
- Post-traumatic stress disorder (PTSD)
- Self-harm
- Substance use disorder
- Suicidal ideation and/or behaviors
Multisystem
- Acid-base imbalance
- Anoxic injury
- Burns
- Comorbidity in patients with transplant history
- Palliative care
- End-of-life
- Failure to thrive
- Fluid and electrolyte imbalances
- Healthcare-associated infections
- Infectious diseases
- Life-threatening maternal/fetal complications(e.g.- eclampsia- HELLP syndrome- maternal/fetal transfusion- placental abruption- placenta previa)
- Multi-organ dysfunction syndrome (MODS)
- Obesity related complications
- Pain
- Rhabdomyolysis
- Sepsis
- Shock states (e.g.- distributive- obstructive)
- Sleep disruption (including sensory overload)
- Submersion injuries (near-drowning)
- Systemic inflammatory response syndrome(SIRS)
- Thermoregulation
- Toxic ingestion/inhalations/exposure
General
- Conduct pain exams
- Evaluate patients response to interventions
- Assess- evaluate & prioritize data collections basedon patient characteristics related to the immediatecondition and anticipated needs
- Manage device alarms based on change in patientcondition
- Manage patient fluid and electrolyte balance
- Provide patient and family-centered care
- Recognize signs and symptoms of emergencies-initiate interventions- and seek assistance as needed
- Recognize indications for and manage patients with/requiring:
- capnography (ETCO2)
- complementary alternative medicine and/ornon-pharmacologic interventions
- intrahospital transport
- medications (e.g.- safe administration-monitoring- polypharmacy)
- pre- and post-operative care
- procedural care
- sedation
- vascular access
- Cardiovascular
- Identify- interpret and respond to cardiac rhythms
- Monitor hemodynamic status and recognize signs andsymptoms of hemodynamic instability
- Recognize early signs of decreased cardiac output
- Recognize indications for and manage patients with/requiring:
- cardiac catheterization
- endovascular procedures
- mechanical circulatory support devices
- non-invasive and invasive hemodynamicmonitoring
- pericardiocentesis
- temporary pacing
- Respiratory
- Recognize indications for and manage patients with/requiring:
- airway management
- bronchoscopy
- chest tubes
- mechanical ventilation
- noninvasive positive pressure ventilation(e.g.- BiPAP- CPAP- high-flow nasal cannula)
- oxygen therapy delivery devices
- prevention of complications related tomechanical ventilation and NIPPV
- prone positioning
- rapid sequence intubation (RSI)
- respiratory monitoring devices (e.g.- SPO2-SVO2- ETCO2)
- therapeutic gases (e.g.- oxygen- nitric oxide-heliox- CO2)
- thoracentesis
- tracheostomy
- Hematology and Immunology
- Recognize indications for and manage patients with/requiring:
- bleeding and clotting disorders
- blood dyscrasias (e.g.- anemia)
- transfusion of blood products- exchangetransfusions- massive transfusions
- Neurological
- Recognize indications for and manage patients with/requiring:
- continuous EEG monitoring
- neuroendovascular interventions (e.g.- coiling-thrombectomy)
- neurologic surgical monitoring devices anddrains (e.g.- ICP- ventricular drain)
- neurosurgical procedures (e.g.- craniotomy-craniectomy- clipping)
- seizure precautions
- spinal precautions
- swallow evaluation
- Integumentary
- Recognize indications for and manage patients with/requiring:
- pressure injury prevention
- therapeutic devices (e.g.- wound VACs- pressurereduction surfaces- ostomy device- fecalmanagement devices- IV infiltrate treatment)
- Gastrointestinal
- Address barriers to nutritional/fluid adequacy (e.g.-chewing/swallowing difficulties- alterations inhunger and thirst- inability to self-feed)
- Recognize indications for and manage patients with/requiring:
- EGD
- enteral and parenteral nutrition
- enteral tubes
- feeding and supplementation
- gastrointestinal drains
- Renal and Genitourinary
- Identify nephrotoxic agents
- Recognize indications for and manage patientsrequiring renal therapeutic intervention(e.g.- hemodialysis- CRRT- peritoneal dialysis)
- Musculoskeletal
- Recognize indications for and manage patients with/requiring:
- compartment syndrome
- early mobility
- Multisystem
- Early sepsis identification
- Monitor and implement strategies to preventhospital acquired infections
- Recognize and manage signs and symptoms of toxin/drug exposure
- Risk factor recognition and management ofmalignant hyperthermia
- Recognize indications for and manage patients with/requiring:
- end-of-life and palliative care
- extracorporeal membrane oxygenation (ECMO)
- intra-abdominal pressure monitoring
- organ donation
- targeted temperature management
- temperature monitoring and regulation devices
- Behavioral and Psychosocial
- conduct behavioral therapeutic interventions
- respond to behavioral emergencies (e.g.- nonviolent crisis intervention- de-escalation techniques)
- utilize behavioral exam tools (e.g.- delirium-alcohol withdrawal- mini-mental status)



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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