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 : NBSTSA-CST
Exam Name : Certified Surgical Technologist
Vendor Name : NBSTSA
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NBSTSA-CST exam Format | NBSTSA-CST Course Contents | NBSTSA-CST Course Outline | NBSTSA-CST exam Syllabus | NBSTSA-CST exam Objectives


The CST examination consists of 175 questions, 150 of which are scored. The 25 pretest items (unscored) are randomly distributed throughout the examination for the purpose of analysis and statistical evaluation. The passing score is the minimum number of questions that must be answered correctly. Candidates should refer to nbstsa.org for the number of questions which must be answered correctly in order to obtain a passing score. Score reports are provided to all candidates who take the examination

I. PERIOPERATIVE CARE (91 items)
A. Preoperative Preparation (18 items)
- Review surgeons preference card.
- Verify availability of surgery equipment (e.g., reserve equipment for surgery).
- Don personal protective equipment.
- Utilize preoperative documentation (e.g., informed consent, advanced directives, allergies, laboratory results).
- Consider patient needs (e.g., bariatrics, geriatrics, pediatrics, immunocompromised, patient allergies).
- Prepare the operating room environment (e.g., temperature, lights, suction, wiping down the room and furniture).
- Coordinate additional equipment (e.g., bovie pad, pneumatic tourniquet, sequential compression devices, thermoregulatory devices, positioning devices).
- Obtain instruments and supplies needed for surgery.
- Perform medical hand wash.
- Check package integrity of sterile supplies.
- Open sterile supplies/instruments while maintaining aseptic technique.
- Perform surgical scrub (e.g., initial, waterless).
- Don gown and gloves.
- Assemble and set up sterile instruments and supplies for surgical procedures.
- Transport the patient to and from operating room.
- Transfer patient to operating room table.
- Apply patient safety devices (e.g., bovie pad, safety strap, protective padding, x-ray safety).
- Apply patient monitoring devices as directed.
- Participate in positioning the patient.
- Prepare surgical site (e.g., hair removal, surgical preparation).
- Gown and glove sterile team members.
- Participate in draping the patient.
- Secure cords/tubing to drapes and apply light handles.
- Drape specialty equipment (e.g., c-arm, Da Vinci, microscope).
- Participate in Universal Protocol (Time Out).

B. Intraoperative Procedures (61 items)
- Maintain aseptic technique throughout the procedure.
- Follow Standard and Universal Precautions.
- Anticipate the steps of surgical procedures.
- Perform counts with circulator at appropriate intervals.
- Verify, receive, mix, and label all medications and solutions.
- Provide intraoperative assistance under the direction of the surgeon.
- Identify different types of operative incisions.
- Identify instruments by:
- function.
- application.
- classification.
- Assemble, test, operate, and disassemble specialty equipment:
- microscopes.
- computer navigation systems.
- thermal technology.
- laser technology (e.g., helium, argon, CO2 beam coagulators).
- ultrasound technology (e.g., harmonic scalpel, phacoemulsification).
- endoscopic technology.
- power equipment.
- Assemble and maintain retractors.
- Pass instruments and supplies.
- Identify appropriate usage of sutures/needles and stapling devices.
- Prepare, pass, and cut suture material as directed.
- Provide assistance with stapling devices.
- Differentiate among the various methods and applications of hemostasis (e.g., mechanical, thermal, chemical).
- Irrigate, suction, and sponge operative site.
- Monitor medication and solution use.
- Verify with surgeon the correct type and/or size of specialty specific implantable items.
- Prepare bone and tissue grafts (e.g., allograft, autograft, synthetic).
- Verify, prepare, and label specimen(s).
- Prepare drains, catheters, and tubing for insertion.
- Observe patients intraoperative status (e.g., monitor color of blood, blood loss, patient position).
- Perform appropriate actions during an emergency.
- Initiate preventative actions in potentially harmful situations.
- Connect and activate drains to suction apparatus.
- Prepare dressings and wound site.
- Assist in the application of casts, splints, braces, and similar devices.

C. Postoperative Procedures (12 items)
- Report medication and solution amount used.
- Participate in case debrief.
- Remove drapes and other equipment (e.g., suction, cautery, instrumentation,nondisposable items) from patient.
- Report abnormal postoperative findings (e.g., bleeding at surgical site,hematoma, rash).
- Dispose of contaminated waste and drapes after surgery incompliance with Standard Precautions.
- Transfer patient from operating table to stretcher.
- Dispose of contaminated sharps after surgery in compliance with Standard Precautions.
- Perform room clean up and restock supplies.

II. ANCILLARY DUTIES (26 items)

A. Administrative and Personnel (9 items)

- Revise surgeons preference card as necessary.
- Follow proper cost containment processes.
- Utilize computer technology for:
- surgeons preference cards
- interdepartmental communication
- continuing education.
- research.
- Follow hospital and national disaster plan protocol.
- Recognize safety and environmental hazards (e.g., fire, chemical spill, laser, smoke).
- Understand basic principles of electricity and electrical safety.
- Apply ethical and legal practices related to surgical patient care.
- Use interpersonal skills (e.g., listening, diplomacy, responsiveness) and group dynamics.
- Understand the importance of cultural diversity.
- Understand concepts of death and dying.
- Participate in organ and tissue procurement.
- Serve as preceptor to perioperative personnel.

B. Equipment Sterilization and Maintenance (17 items)
- Troubleshoot equipment malfunctions.
- Decontaminate and clean instruments and equipment.
- Inspect, test, and assemble instruments and equipment.
- Sterilize instruments for immediate use (e.g., short cycle).
- Package and sterilize instruments and equipment.

III. BASIC SCIENCE (33 items)

A. Anatomy and Physiology (20 items)

- Use appropriate medical terminology and abbreviations.
- Demonstrate knowledge of anatomical systems as they relate to the surgical procedure:
- cardiovascular.
- endocrine.
- gastrointestinal.
- genitourinary.
- integumentary.
- lymphatic.
- muscular.
- neurological.
- ophthalmic.
- otorhinolaryngology.
- peripheral vascular.
- pulmonary.
- reproductive.
- skeletal.

- Demonstrate knowledge of human physiology as they relate to the surgical procedure:
- cardiovascular.
- endocrine.
- gastrointestinal.
- genitourinary.
- integumentary.
- lymphatic.
- muscular.
- neurological.
- ophthalmic.
- otorhinolaryngology.
- peripheral vascular.
- pulmonary.
- reproductive.
- skeletal.
- Identify the following surgical pathologies:
- abnormal anatomy.
- disease processes.
- malignancies.
- traumatic injuries.

B. Microbiology (6 items)
- Apply principles of surgical microbiology to operative practice:
- classification and pathogenesis of microorganisms (e.g., cultures).
- infection control procedures (e.g., aseptic technique).
- principles of tissue handling (e.g., Halsted principles, tissue manipulation methods, traction/counter traction).
- stages of, and factors influencing wound healing (e.g., condition of patient, wound type).
- surgical wound classification.
- Identify and address factors that can influence an infectious process.

C. Surgical Pharmacology (7 items)
- Apply principles of surgical pharmacology to operative practice:
- anesthesia related agents and medications.
- blood and fluid replacement.
- complications from drug interactions (e.g., malignant hyperthermia).
- methods of anesthesia administration (e.g., general, local, block).
- types, uses, action, and interactions of drugs and solution (e.g., hemostaticagents, antibiotics, IV solutions).
- weights, measures, and conversions.
- Maintain awareness of maximum dosage.



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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