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 : CGRN
Exam Name : ABCGN Certified Gastroenterology Registered Nurse
Vendor Name : Medical
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CGRN test Format | CGRN Course Contents | CGRN Course Outline | CGRN test Syllabus | CGRN test Objectives


The Exam: There is one ABCGN certification examination for RNs. The examination is based on role delineations -- surveys of practitioners, which define the scope of practice and the knowledge and skills required to function in the field. All examination items are written by certified individuals with expertise in the field of gastroenterology and/or gastroenterology endoscopy nursing practice.

Test Items (Questions): Test items are reviewed, referenced and validated by the ABCGN Item Writers Committee and, finally, edited by the testing company for construction, grammatical correctness and clarity. test Content The CGRN examination each consist of 175 multiple-choice questions. Each question has four choices and one correct answer. Candidates have three hours to complete their examination.

The CGRN examination contains questions from four major content areas: general nursing care, gastroenterological procedures, patient care interventions and environmental safety, infection prevention and control. All questions are directly related to the GI specialty. More specific information regarding the content of the examinations is included in the Appendix of the Certification Handbook.

Preparation for the Exam: ABCGN does not sponsor or endorse test preparation or review courses for the certification examinations. SGNA, ABCGN's sister organization, offers both courses and materials for the test and recertification. Visit the SGNA website for more details.

1. General Nursing Care 24%
2. Gastroenterological Procedures 33%
3. Patient Care Interventions 27%
4. Environmental Safety, Infection Prevention and Control 16%

Domain I: General Nursing Care
Task A: Assess and analyze the patients health status through data collection.
Knowledge of:
1. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
2. Physiological, psychological, social, cultural, and spiritual aspects of their wellness
3. Pharmacology (e.g. Prescription medication, OTC, supplements-herbal)
Task B: Monitor and assess the patients health status to determine necessary nursing interventions.
Knowledge of:
Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
2. Physiological, psychological, social, cultural, and spiritual aspects of their wellness
3. Pharmacology (e.g. compliance/noncompliance issues, education, drug interaction)
4. Advocating and protecting patients rights and privacy (e.g. HIPAA, ethics)
Task C: Educate the patient through effective communication to develop a plan of care directed to the patients level of understanding.
Knowledge of:
1. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
2. Physiological, psychological, social, cultural, and spiritual aspects of their wellness
3. Pharmacology (e.g. Prescription medication, OTC, supplements-herbal)

Domain II: Gastroenterological Procedures
Task A: Collaborate with the health care team during endoscopic procedures to provide safe and effective care.
Knowledge of:
1. Endoscopic procedures ( e.g. diagnostic, interventional)
2. Equipment and accessories
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Environment of care (e.g. thermal burns, chemical spills, radiation, time out)
5. Pharmacology(e.g. sedation medication, reversal agents, procedure medications, resuscitative medication)
6. Physiological, psychological, social, spiritual, and cultural aspects of wellness
7. Potential complications and anticipated interventions (e.g. hemorrhage, perforation, compromised airway, medication reaction)
8. Specimen processing and handling (e.g. labeling, storage, transportation)
Task B: Collaboration with the health care teamduring non-endoscopic procedures to provide safe and effective care.
Knowledge of:
1. Non-endoscopic procedures (e.g. diagnostic, interventional)
2. Equipment and accessories (e.g. needles, probes, capsules, ligature, PEG exchange)
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Environment of care (e.g. spills, time out)
5. Pharmacology(e.g. learning needs, sedation medication, reversal agents, procedure medications, resuscitative medication)
6. Physiological, psychological, social, spiritual, and cultural aspects of wellness
7. Potential risks, complications, and interventions
8. Specimen processing and handling (e.g. labeling, storage, transportation)
Task C: Perform non-endoscopic procedures to promote optimal patient outcomes.
Knowledge of:
1. Non-endoscopic procedures (e.g. diagnostic, interventional)
2. Equipment and accessories (e.g. probes, capsules, PEG exchange)
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Environment of care (e.g. time out, spills)
5. Pharmacology (e.g. biologics)
6. Physiological, psychological, social, spiritual, and cultural aspects of wellness
7. Potential risks, complications, and interventions
8. Specimen processing and handling (e.g. labeling, storage, transportation)

Domain III: Patient Care Interventions
Task A: Recognize and respond to emergent changes in the patients status to prevent complications and maximize positive outcomes.
Knowledge of:
1. Potential risks, complications, and anticipated interventions (e.g. underlines conditions)
2. Resuscitation procedures and equipment
3. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
4. Emergency medications (e.g. Romazicon, Atropine, Narcan, Epinephrine)
5. Sedation guidelines and principles (e.g. ASA, airway status)
Task 2: Promoting wellness by managing GI health care needs.
Knowledge of:
1. Diet and Nutrition (e.g. supplements, high fiber diet, other specialized diets, diet modifications)
2. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
3. Therapeutic interventions in pain management (e.g. ambulation, medication, positioning)
4. Patients rights and responsibilities (e.g. advanced directives)
5. Pharmacology (e.g. PPI, laxative, pro-biotics, biologics, timing of medication)
6. Potential complications (e.g. flare ups, drug reactions/interactions)
7. Physiological, psychological, social, sexual, spiritual, and cultural aspects of wellness
8. Resources (e.g. palliative, support group, financial and social assistance)
Task C: Administer medications and fluids consistent to provide safe and effective care.
Knowledge of:
1. Established standards for administering medications and fluids (e.g. safe injection practices)
2. Normal and abnormal gastrointestinal anatomy, physiology, and pathophysiology
3. Pharmacology (e.g. biologics infusions/injections, antibiotic, timing of medication)
4. Physiological, psychological, social, cultural, and spiritual aspects of wellness
5. Potential adverse reactions, complications, and anticipated interventions

Domain IV: Environmental Safety, Infection Prevention and Control
Task A: Procedure related infection prevention and control.
Knowledge of:
1. Standard for infection control in an endoscopy setting (e.g. validation of competencies, manufactures guidelines, PPE, spills)
2. Equipment reprocessing (e.g. Scopes and accessories, bioburden)
3. Sterilization and high level disinfection (e.g. Spaulding classification, single use devices vs. reusable devices, minimal effective concentration of disinfection solutions
4. Safe Injection practices (e.g. multi-dose vial)
5. Body mechanics (e.g. ergonomics, patient pressure, repetitive injuries)
6. Electrical, Laser, Radiation, Chemical (e.g. grounding pad placement, piercings, return electrode)
Task B: Environmental Safety, Infection Prevention and Control in Gastroenterology
Knowledge of:
1. Patient education related to disease (e.g. Crohns, C-DIFF, VRE, CRE)
2. Bloodborne pathogen (e.g. Hepatitis C, transmission)
3. Multidrug resistance organisms (e.g. MDRO, VRE, CRE)
4. Personal Protective Equipment (e.g. standard precautions, communication devices, attire)



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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