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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AACN CCRN-Pediatric : Critical Care Register Nurse - Pediatric exam Questions, MCQs and Practice Test

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


Exam Code: CCRN-Pediatric
Exam Name: Critical Care Register Nurse - Pediatric
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
- Cardiac infection and inflammatory diseases
- Cardiac malformations
- Cardiac surgery
- Cardiac transplant
- Cardiac/vascular catheterization
- Cardiogenic shock
- Cardiomyopathies
- Dysrhythmias
- Heart failure
- Hepertensive crisis
- Myocardial conduction system defects (e.g.,prolonged QT interval, Wolff-Parkinson-White)
- Vascular occlusions
Respiratory
- Acute pulmonary embolus
- Acute respiratory distress syndrome (ARDS)
- Acute respiratory failure
- Acute respiratory infection
- Chronic respiratory failure
- Chrnoic pulmonary conditions
- Airway malformations
- 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
- Endocrine
- Diabetes mellitus
- Diabetic ketoacidosis (DKA)
- Hyperglycemia
- Hypoglycemia
- Diabetes insipidus (DI), syndrome ofinappropriate antidiuretic hormonesecretion (SIADH), cerebral salt wasting(CSW)
- Hematology and Immunology
- Anemia
- Bone marrow transplant
- Coagulopathies (e.g., ITP, DIC, HIT)
- Immune deficiencies
- Myelosuppression (e.g., thrombocytopenia,neutropenia)
- Oncologic complications (e.g., tumor lysissyndrome, neutropenia)
- Sickle cell crisis
- 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 abnormalities
- GI surgeries (e.g., Whipple, esophagectomy,resections)
- Hepatic disease and failure/coma
- Liver transplant
- Malnutrition and malabsorption
- Peritonitis
- Renal and Genitourinary
- Acute kidney injury (AKI)
- Chronic kidney disease (CKD)
- Hemolytic uremic syndrome (HUS)
- Kidney transplant
- Life-threatening electrolyte imbalances
- Integumentary
- IV infiltration/extravasation
- Pressure injury
- Skin failure (e.g., hypoperfusion)
- Wounds
Musculoskeletal, Neurological, BehavioralPsychosocial
- Musculoskeletal
- Compartment syndrome
- Musculoskeletal trauma
- Rhabdomyolysis
- Neurological
- Acute spinal cord injury
- Brain death
- Congenital neurological abnormalities
- Delirium
- Encephalopathy
- Intracranial hemorrhage
- Stroke
- Hydrocephalus
- Neurologic infectious disease
- Neuromuscular disorders
- Neurosurgery
- Seizure disorders
- Space-occupying lesions
- Spinal fusion
- Traumatic brain injury
- Behavioral and Psychosocial
- Abuse/neglect/maltreatment
- Medical non-adherence
- Mood disorders, depression, anxiety
- Post-intensive care syndrome (PICS)
- Suicidal ideation and/or behaviors
Multisystem
- Acid-base imbalance
- Burns, thermal injury/exposure
- End-of-life
- Palliative care
- Healthcare-acquired conditions (HAC)
- Multi-organ dysfunction syndrome (MODS)
- Tissue and organ donation
- Pain: acute and chronic
- Systemic inflammatory response syndrome(SIRS)
- Sepsis
- Shock states (e.g., distributive, hypovolemic,obstructive)
- Submersion injuries (near-drowning)
- Toxic ingestion/inhalation/exposure
General
- Identify signs and symptoms of clinical deterioration,initiate nursing interventions, and seek assistance asneeded
- Conduct a comprehensive physical and psychosocialassessment
- Evaluate diagnostic test results and anticipateinterventions
- Interpret laboratory and blood gas results andanticipate interventions
- Provide family-centered care
- Conduct developmentally appropriate painassessment
- Manage tissue and organ donors
- Manage monitor alarms based on protocols andchanges in patient condition
- Prevention and management of healthcare acquiredconditions/events
- Recognize indications for and manage patients with/requiring:
- complementary alternative medicine and/ornon-pharmacologic interventions
- intra-procedural and post-procedural care
- medications (e.g., safe administration,monitoring, polypharmacy, sedation)
- fluid and electrolyte replacement
- palliative care
- end-of-life care
- pre- and post-operative care
- procedural sedation
- temperature monitoring and regulation devices
- bone fracture prevention and/or treatment
- vascular access
- Cardiovascular
- Identify, interpret and respond to cardiac rhythms
- Monitor hemodynamic status and recognize signsand symptoms of hemodynamic instability
- Recognize indications for and manage patients with/requiring:
- 12-lead ECG
- cardioversion (pharmacologic, nonpharmacologic, electrical)
- defibrillation
- invasive hemodynamic monitoring (e.g., arterialcatheter, central venous pressure monitoring)
- near infrared spectroscopy (NIRS)
- temporary pacing
- ventricular assist device (VAD)
- Respiratory
- Assess and prevent complications related tomechanical ventilation
- Recognize indications for and manage patients with/requiring:
- artificial airways (e.g., endotracheal tube,tracheostomy, LMA)
- non-invasive ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)
- invasive ventilation (e.g., conventionalmechanical ventilation)
- non-conventional mechanical ventilation (e.g.,high-frequency, jet)
- chest tubes
- prone positioning
- rapid sequence itubation (RSI)
- therapeutic gases (e.g., oxygen, nitric oxide,heliox, CO2)
- Hematology and Immunology
- Recognize indications for and manage patients with/requiring:
- plasmapheresis, exchange transfusion, orleukocyte depletion
- transfusion of blood and blood products
- Neurological
- Recognize indications for and manage patients with/requiring:
- neuroprotective protocols
- neurologic monitoring devices and drains (e.g.,ICP, ventricular drain)
- seizure precautions
- spinal precautions
- brain death exam
- Integumentary
- Prevent and manage surgical site infection
- Manage patients requiring wound prevention and/ortreatment
- Gastrointestinal
- Recognize indications for and manage patients with/requiring:
- intra-abdominal pressure monitoring
- inadequate nutrition and fluid intake
- enteral and parenteral nutrition
- enteral tubes
- gastrointestinal drains
- necrotizing enterocolitis (NEC)
- Renal and Genitourinary
- Recognize indications for and manage patients requiring renal therapeutic intervention (e.g.hemodialysis, CRRT, peritoneal dialysis)
- Multisystem
- Early and late sepsis identification and treatment
- Monitor and implement strategies to preventhospital acquired infections
- Recognize indications for and manage patientsrequiring progressive mobility
- Manage patients requiring extracorporeal membraneoxygenation (ECMO)
- Behavioral and Psychosocial
- Conduct behavioral exam (e.g., delirium,withdrawal)
- Manage patients requiring behavioral and mentalhealth interventions
- Respond to behavioral emergencies (e.g., nonviolentcrisis intervention, de-escalation techniques)
- Recognize indications for and manage patientsrequiring restraints



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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