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 : DNCB-DNC
Exam Name : Dermatology Nurse Certified (DNC)
Vendor Name : DNCB
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DNCB-DNC test Format | DNCB-DNC Course Contents | DNCB-DNC Course Outline | DNCB-DNC test Syllabus | DNCB-DNC test Objectives


Exam Code: DNCB-DNC
Exam Name: DNCB Dermatology Nurse Certified (DNC)
Number of Questions: The DNC test consists of 175 multiple-choice questions. Approximately 25 of these questions are unscored pretest items.
Time Limit: Candidates are typically given 4 hours to complete the exam.
Administration: The test is computer-based and administered by C-NET at various testing locations.
Passing Score: A score of approximately 75% is generally required to pass.
Credential: Upon successful completion, candidates earn the credential "Dermatology Nurse Certified (DNC)."

I. Core Dermatology Nursing Practice

- Skin Anatomy and Physiology:
- Structure and function of the epidermis, dermis, subcutaneous tissue.
- Appendages: hair, nails, sebaceous glands, sweat glands.
- Skin functions (e.g., protection, thermoregulation, sensation, vitamin D synthesis).

- Skin Assessment:
- Comprehensive history taking (e.g., chief complaint, past medical history, social history, medications, allergies).
- Physical examination techniques (inspection, palpation, description of lesions).
- Documentation of skin findings.

- Pharmacology and Therapeutics in Dermatology:
- Topical medications (e.g., corticosteroids, antifungals, antibiotics, retinoids, emollients, calcineurin inhibitors).
- Systemic medications (e.g., oral antibiotics, antifungals, corticosteroids, immunosuppressants, biologics).
- Drug administration routes and patient education.
- Adverse effects and contraindications of common dermatologic drugs.

- Patient Education:
- Skin care regimens (e.g., sun protection, moisturization, wound care).
- Disease specific education (e.g., trigger avoidance, medication adherence).
- Lifestyle modifications for dermatological conditions.

- Epidermis, Dermis, Subcutaneous tissue, Keratinocytes, Melanocytes, Langerhans cells, Merkel cells, Collagen, Elastin.
- Macule, Papule, Nodule, Plaque, Vesicle, Bulla, Pustule, Wheal, Urticaria, Erosion, Ulcer, Fissure, Crust, Scale, Lichenification, Atrophy, Scar, Excoriation.
- Pruritus, Erythema, Edema, Induration, Purpura, Petechiae, Ecchymosis, Telangiectasia.
- Topical, Systemic, Ointment, Cream, Lotion, Gel, Solution, Foam, Powder, Suspension, Emollient, Humectant, Occlusive.
- Pharmacokinetics, Pharmacodynamics, Half-life, Bioavailability, Side effects, Adverse drug reactions.

II. Dermatological Conditions and Management

- Inflammatory Skin Conditions:
- Acne (vulgaris, rosacea): pathogenesis, clinical presentation, treatment.
- Eczema/Dermatitis (e.g., atopic, contact, seborrheic, stasis): causes, clinical features, management.
- Psoriasis (e.g., plaque, guttate, inverse, pustular, erythrodermic): types, pathophysiology, systemic associations, treatment modalities (topical, phototherapy, systemic, biologics).
- Urticaria and Angioedema: causes, acute vs. chronic, management.

- Infectious Skin Conditions:
- Bacterial (e.g., impetigo, cellulitis, folliculitis, erysipelas): causative agents, clinical signs, antibiotics.
- Fungal (e.g., tinea infections, candidiasis): types, diagnosis, antifungals.
- Viral (e.g., herpes simplex, herpes zoster, warts, molluscum contagiosum): presentation, antiviral therapy, other treatments.
- Parasitic (e.g., scabies, pediculosis): diagnosis, treatment.

- Pigmentary Disorders:
- Hyperpigmentation (e.g., melasma, post-inflammatory hyperpigmentation).
- Hypopigmentation (e.g., vitiligo, post-inflammatory hypopigmentation).

- Hair and Nail Disorders:
- Alopecia (e.g., androgenetic, alopecia areata, telogen effluvium).
- Nail dystrophies (e.g., onychomycosis, psoriasis of nails).
- Autoimmune and Connective Tissue Diseases with Skin Manifestations:
- Lupus erythematosus (cutaneous forms).
- Scleroderma.
- Dermatomyositis.
- Bullous diseases (e.g., pemphigus, bullous pemphigoid).

- Pediatric Dermatology:
- Common conditions in children (e.g., diaper rash, infantile eczema, birthmarks).
- Age-specific considerations for treatment and patient education.

- Geriatric Dermatology:
- Age-related skin changes.
- Common conditions in the elderly (e.g., xerosis, stasis dermatitis, skin tears).
- Considerations for treatment and education in older adults.

- Acne vulgaris, Rosacea, Comedones, Papules, Pustules, Cysts.
- Atopic dermatitis, Contact dermatitis (irritant, allergic), Seborrheic dermatitis, Stasis dermatitis.
- Psoriasis (plaque, guttate, inverse, pustular, erythrodermic), Koebner phenomenon, Auspitz sign.
- Urticaria, Angioedema.
- Impetigo, Cellulitis, Erysipelas, Folliculitis, Abscess, Furuncle, Carbuncle.
- Tinea (pedis, corporis, cruris, capitis), Candidiasis.
- Herpes simplex, Herpes zoster, Varicella, Warts (verrucae), Molluscum contagiosum.
- Scabies, Pediculosis.
- Melasma, Vitiligo, Post-inflammatory hyperpigmentation/hypopigmentation.
- Alopecia, Onychomycosis, Onycholysis.
- Lupus, Scleroderma, Dermatomyositis, Pemphigus, Bullous pemphigoid.
- Xerosis, Pruritus senilis.

III. Surgical and Procedural Dermatology

- Biopsy Techniques:
- Punch biopsy, shave biopsy, excisional biopsy.
- Specimen handling and proper submission.

- Surgical Excisions:
- Indications, pre-operative preparation, sterile technique, wound closure, post-operative care.

- Cryosurgery:
- Indications, technique, post-procedure care.
- Electrosurgery (e.g., electrocautery, electrodesiccation):
- Principles, indications, post-procedure care.

- Phototherapy (e.g., UVB, UVA, PUVA):
- Indications, patient selection, dosage, side effects, safety measures.

- Laser Therapy:
- Types of lasers (e.g., ablative, non-ablative, pulsed dye, Nd:YAG), indications (e.g., vascular lesions, pigmentary lesions, hair removal, skin resurfacing), patient safety.

- Chemical Peels:
- Types (superficial, medium, deep), indications, pre- and post-peel care.

- Injectables (e.g., botulinum toxin, dermal fillers):
- Indications, administration, potential complications.

- Wound Care and Management:
- Wound healing phases, types of wounds (e.g., acute, chronic, pressure injuries), dressing selection, debridement.

- Infection Control in Dermatologic Procedures:
- Aseptic technique, sterilization, disinfection.

- Biopsy (punch, shave, excisional), Curettage, Electrocautery, Electrodesiccation.
- Cryosurgery, Liquid nitrogen.
- Phototherapy, UVB, UVA, PUVA, Psoralen.
- Laser (ablative, non-ablative, pulsed dye, Nd:YAG, CO2, Er:YAG), Chromophore.
- Chemical peel (glycolic acid, salicylic acid, trichloroacetic acid), Superficial, Medium, Deep.
- Botulinum toxin, Dermal fillers (hyaluronic acid, calcium hydroxylapatite).
- Wound healing (inflammation, proliferation, remodeling), Primary intention, Secondary intention, Tertiary intention.
- Debridement, Dressings (occlusive, semi-occlusive, hydrocolloid, alginate, foam, silicone).
- Aseptic technique, Sterilization, Disinfection.

IV. Professional Practice and Healthcare Outcomes

- Ethical and Legal Considerations:
- Patient confidentiality (HIPAA), informed consent, scope of practice, documentation standards.
- Professional boundaries, cultural competence.

- Quality Improvement and Safety:
- Medication safety, patient identification, fall prevention, infection prevention.
- Risk management in dermatology.

- Interdisciplinary Collaboration:
- Working with physicians, physician assistants, medical assistants, aestheticians, and other healthcare professionals.
- Referral processes.

- Research and Evidence-Based Practice:
- Utilizing current research to guide nursing practice.
- Understanding research methodologies and statistical significance.

- Professional Development:
- Continuing education, certification renewal, participation in professional organizations (e.g., DNA).

- HIPAA, Informed consent, Scope of practice, Malpractice, Negligence.
- Quality improvement, Patient safety, Root cause analysis.
- Interdisciplinary team, Collaboration, Referral.
- Evidence-based practice, Clinical guidelines, Research utilization.
- Continuing education, Certification, Professional organizations.



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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