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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Our affiliated professional association, the Academy of Medical-Surgical Nurses, offers the Medical-Surgical Nursing Certification Review Course. It is a 2-day course designed for nurses preparing to take the Certified Medical-Surgical Registered Nurse (CMSRN®) Certification Exam.
In order to meet the varied needs of nurses and facilities, AMSN offers the course in a number of live and independent study formats, including bringing it to your facility or accessing it through the AMSN Online Library.
An alternative to nurses preparing for the CMSRN exam is the Focused CE Series, a collaboration between AMSN and nurse.com. The Focused CE Series is a blended learning model that combines weekly online CE course readings, weekly live webinar presentations, and an online forum for information exchange and networking with peers.
1. Helping Role
- Maintain an environment in which patient confidentiality is assured.
- Assess patient's level of comfort/pain.
- Act as an advocate to help patient meet needs/goals.
- Acknowledge, respect, and support emotional state of patient and/or family as they experience and/or express their emotions.
- Assist patients to achieve optimal level of comfort, using an interdisciplinary approach.
- Modify plan of care to achieve patient's optimal level of comfort, i.e., pharmacological interventions, heat, cold, massage, positioning, touch, etc.
- Provide a therapeutic environment, considering privacy, noise, light, visitors'/providers' interaction with patients.
- Provide culturally competent patient care, including education.
- Support family involvement in accordance with patient's wishes regarding caregiving and decision making.
- Assess for potential for self-harm.
- Identify need of patient/family for support systems/resources and make appropriate referrals.
- Work on behalf of patient/family to help resolve ethical and clinical concerns.
- Coordinate care across multiple settings.
- Identify, acknowledge, support, and facilitate patient/family decisions regarding end-of-life care.
- Identify signs of domestic or intimate partner violence.
- Assess and provide for spiritual needs of patients and families.
- Identify ethical issues in clinical practice and facilitate a resolution with patient, family, and staff.
2. Teaching/Coaching Function
- Assess the patient's and family's readiness and ability to learn.
- Identify barriers to learning.
- Prepare/educate patient for transition in care, e.g., discharge to home or other facility.
- Provide information and rationales related to diagnosis, procedures, self-care, prognosis, wellness, and modifiable risk factors.
- Utilize opportunities for spontaneous education.
- Encourage patient's and family's participation in establishing educational goals.
- Develop and implement an individualized teaching plan for patient and/or family.
- Evaluate and modify teaching plan based on achievement of pre-established and ongoing learning needs.
- Assist staff in identifying educational needs of patients and their families.
- Assist staff in selecting/developing educational materials appropriate for intended learner(s).
- Teach patient and family about available community resources.
3. Diagnostic and Patient Monitoring
- Conduct and document a comprehensive baseline exam.
- Anticipate patient's response to treatment and monitor for potential problems.
- Reassess patient based on established standards of care at appropriate intervals.
- Interpret results of laboratory and diagnostic studies and take appropriate action.
- Use invasive and non-invasive methods to collect data.
- Analyze all patient data in formulating a plan of care.
- Participate in medication reconciliation at transitions of care.
- Anticipate the patient's response and needs related to physiological, psychosocial sexual, spiritual, and cultural aspects of his/her illness.
- Prioritize identified problems and modify the plan of care to achieve the best possible outcomes.
- Develop an individualized plan of care congruent with patient goals.
- Identify purpose and appropriateness of diagnostic studies.
4. Administering and Monitoring Nursing Interventions
- Administer medications accurately and safely.
- Identify subtle changes in patient's exam to prevent deterioration of patient status.
- Assess patient's level of consciousness.
- Monitor patients for therapeutic responses, reactions, untoward effects, toxicity, and incompatibilities of administered medications.
- Implement measures to ensure adequate oxygenation and gas exchange.
- Monitor and implement measures to prevent alterations in skin integrity.
- Initiate, maintain, and monitor intravenous therapy.
- Identify, document, and report deviations from expected findings.
- Monitor for signs and symptoms of complications of disease processes.
- Implement measures to address threats to patient safety, e.g., falls, seizures.
- Maintain patent airway.
- Maintain integrity and prevent infection of invasive drainage systems, e.g., catheters, percutaneous drains.
- Implement measures to maintain adequate hydration and electrolyte balance.
- Provide care to patients on continuous cardiac monitoring.
- Use adaptive/assistive devices for mobility, immobility, positioning, and comfort.
- Interpret cardiac rhythm strips.
- Monitor for complications of musculoskeletal trauma and surgical procedures.
- Perform a neurovascular exam, e.g., extremities, flaps, grafts.
- Provide optimum nutrition during hospitalization, allowing for cultural and individual preferences.
- Identify and implement transmission-based precautions based on patient's history and symptoms.
- Monitor effectiveness of nutritional interventions.
- Develop and implement a wound management strategy.
- Care for patient receiving IV patient-controlled analgesia
- Perform central line dressing change.
- Administer heparin drip
- Apply and/or monitor devices used to immobilize affected area, e.g., cast, splint, collar, etc.
- Care for patient receiving epidural analgesia
- Provide care for patients who have chest drainage systems.
5. Effective Management of Rapidly Changing Situations
- Recognize signs that a patients condition is deteriorating and take appropriate action.
- Obtain appropriate orders to address a change in the patients condition,
- Determine priorities in rapidly changing situations.
- Use existing guidelines/protocols/policies to respond to changing patient situations, e.g., hypoglycemia, wound dehiscence.
- Use existing guidelines/protocols/policies to respond to urgent and emergent situations, e.g., acute chest pain, stroke.
- Initiate basic life support.
6. Monitoring/Ensuring Quality Health Care Practices
- Communicate effectively to the healthcare team.
- Question/clarify orders as appropriate.
- Incorporate evidence-based practice into the patient's plan of care.
- Coordinate and/or participate in interdisciplinary activities to ensure consistent patient outcomes, e.g., core measures.
- Report system failures, e.g., chain of command, equipment, safety, medication administration, computer systems.
- Assist nursing staff in incorporating evidence-based practice and quality improvement into practice.
- Participate in quality improvement activities.
- Identify clinical problems for further investigation.
7. Organizational and Work-Role Competencies
- Practice in accordance with the rules and regulations of the state board of nursing in state(s) of licensure.
- Adhere to the Scope and Standards of Medical-Surgical Nursing Practice.
- Utilize electronic/computer resources to optimize patient care.
- Set priorities based on assignment, unit, and institutional needs.
- Act as a professional role model.
- Participate as an active member of the interdisciplinary healthcare team.
- Delegate patient care assignments based on competency levels and scope of practice of healthcare team members.
- Act as a resource for other nurses on the unit.
- Provide collaborative, interdisciplinary, coordinated care.
- Incorporate strategies that support effective team dynamics in a caring and nurturing environment.
- Evaluate own practice based on established standards of care.
- Evaluate nursing care based on outcome criteria.
- Recognize unsafe work practices (nurse/patient ratio, ergonomics, standard precautions, etc.) and intervene appropriately.
- Identify, develop, and implement strategies to reduce readmissions.
- Use the chain of command appropriately.
- Serve as consultant to nursing staff and other disciplines.
- Coordinate and/or participate in interdisciplinary activities to ensure consistent patient outcomes, e.g., core measures.
- Identify, develop, and implement strategies to decrease length of stay while improving patient/family/staff satisfaction and patient care.
- Provide expert support to unit educators, preceptors, and nurse managers.
- Follow institutional policies and procedures in response to an internal or external crisis or event.
- Serve as preceptor/mentor for students and staff.
- Assist with data collection (e.g., patient outcomes, nurse-sensitive indicators).
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Medical Certification exam Braindumps
ChatGPT Passed a Major Medical Exam, but Just BarelyAnyone anxiously holding their breath for a competent robot doctor may need to wait a bit longer. A group of AnsibleHealth AI researchers recently put OpenAI’s ChatGPT to the test against a major medical licensing exam and the results are in. The AI chatbot technically passed, but by the skin of its teeth. When it comes to medical exams, even the most impressive new AI still performs at a D level. The researchers say that lackluster showing is nonetheless a landmark achievement for AI. David Byrne on New Tech and AI | Gizmodo Interview The researchers tested ChatGPT on the United States Medical Licensing exam (USMLE), a standardized series of three exams required for U.S. doctors vying for a medical license. ChatGPT managed to score between 52.4% and 75% across all three levels of the exam. That might not sound great to all of the overachievers out there, but it’s about on par with the 60% passing threshold for the exam. Researchers involved in the study claim this marks the first time AI was able to perform at or near the passing threshold for the notoriously difficult exam. Crucially, ChatGPT was able to pass without any extra specialized inputs from human trainers. “Reaching the passing score for this notoriously difficult expert exam, and doing so without any human reinforcement, marks a notable milestone in clinical AI maturation,” the authors wrote in the journal PLOS Digital Health. Mediocre test scores aside, the researchers praised ChatGPT for its ability to craft authentic sounding, original answers. ChatGPT managed to create, “new, non-obvious, and clinically valid insights,” for 88.9% of its responses and appeared to show evidence of deductive reasoning, chain of thought, and long term dependency skills. Those findings appear somewhat unique to ChatGPT and its particular style of AI learning. Unlike previous generations of systems that use deep learning models, ChatGPT relies on a large language model trained to predict a sequence of words based on the context of the words that came before. That means, unlike other AIs, ChatGPT can actually generate sequences of words that weren’t previously seen by the algorithm and that could make some coherent sense. The tricky USMLE exams test participants on basic science, clinical reasoning, medical management, and bioethics. They’re most often taken by medical students and physicians in training. These exams are also standardized and regulated, which makes them particularly well suited to test out ChatGPT’s capabilities, the researchers said. One thing the exams definitely aren’t is easy. Human students typically spend around 300-400 hours stressfully pouring over dense scientific literature and testing material in preparation just for the Step 1 exam, the first of the three. Surprisingly, ChatGPT managed to outperform PubMedGPT, another large language model AI trained exclusively on biomedical literature. That may seem counterintuitive at first, but the researchers say ChatGPT’s more generalized training may actually supply it a leg up because it’s potentially exposed to a broader range of clinical content like patient-facing disease primers or drug package inserts. The researchers optimistically believe ChatGPT’s passable grade could hint towards a future where AI systems can play an assisting role in medical education. That’s already happening on a small level, they write, citing a exact example of AnsibleHealth clinicians using the tool to rewrite dense, jargon filled reports. “Our study suggests that large language models such as ChatGPT may potentially assist human learners in a medical education setting, as a prelude to future integration into clinical decision-making,” the researchers said. In a rather meta twist, ChatGPT wasn’t just tasked with taking the medical exam. The system was also involved with drafting the eventual research paper documenting its performance. Researchers say they interacted with ChatGPT, “much like a colleague” and leaned on it to synthesize and simplify their draft and even provide counterpoints. “All of the co-authors valued ChatGPT’s input,” Tiffany Kung, one of the researchers wrote. ChatGPT has added an impressive amount of passing grades to its educational trophy wall in exact months. Last month, ChatGPT managed to score between a B and B minus on a MBA-level exam given to business students at the prestigious Wharton School of the University of Pennsylvania. Right around the same time, the AI achieved a passing score on a law exam given to students at the Minnesota University Law School. In the law exam case, ChatGPT skirted by with a C+. “Alone, ChatGPT would be pretty mediocre law student,” lead study author Jonathan Choi said in an interview with Reuters. “The bigger potential for the profession here is that a lawyer could use ChatGPT to produce a rough first draft and just make their practice that much more effective.” ChatGPT might be able to eke out passable scores in exams focused on writing and memorizing comprehension, but mathematics is another beast entirely. Despite its impressive ability to bust out academic papers and semi-conceiving prose, researchers say the AI only performs at roughly a 6th grade level when it comes to math. ChatGPT fares even worse when it’s asked basic arithmetic problems in natural language format. That stumbling stems from its predictive large language model training. ChatGPT will, of course, confidently provide you an answer to your math problem, but it could be completely divorced from reality. ChatGPT’s at time wacko answers are what senior Google engineers and other in the field have referred to, cautiously, as AI “hallucinations.” These AI hallucinations create answers that seem convincing but are partially or completely made up, which isn’t exactly a great sign for anyone looking to authoritative AI’s in high-stakes fields like medicine and law. “It [ChatGPT] acts like an expert, and sometimes it can provide a convincing impersonation of one,” University of Texas professor Paul von Hippel said in a exact interview with The Wall Street Journal. “But often it is a kind of b.s. artist, mixing truth, error and fabrication in a way that can sound convincing unless you have some expertise yourself.” Online Medical Assistant Certification ProgramObtaining a CPC, CCA, or CBCS certification implies that an individual has met competencies in the field of medical billing and coding. Certification is invaluable to the student's career goals. Students have an opportunity to make confident, informed decisions about the national certification they prefer. The Certified Professional Coder (CPC) exam is offered by the American Academy of Professional Coders (AAPC). It is the gold standard entry-level coding certification for physician, or professional fee, coders. The Certified Coding Associate (CCA) is offered by the American Health Information Management Association (AHIMA). It is an entry-level medical coding certification across all settings--physician practices and inpatient hospital. The Certified Billing and Coding Specialist (CBCS) is offered by the National Healthcareer Association (NHA) and is currently an entry-level medical billing certification for physician practices. In the summer of 2021, the exam will transition to an entry-level billing and coding certification, with the inclusion of ICD-10-CM, CPT, and HCPCS Level II testing. 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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