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 : PCCN
Exam Name : AACN Progressive Critical Care Nursing
Vendor Name : Medical
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PCCN test Format | PCCN Course Contents | PCCN Course Outline | PCCN test Syllabus | PCCN test Objectives


The PCCN and PCCN-K certification exams focus 80 percent on clinical judgment and 20 percent on professional caring and ethical practice. Their comprehensive course prepares you in the following categories:

Clinical Judgment

- Cardiovascular
- Pulmonary
- Endocrine
- Hematology
- Gastrointestinal
- Renal
- Neurology
- Behavioral/Psychosocial
- Musculoskeletal
- Professional Caring and Ethical Practice
- Advocacy/Moral Agency
- Caring Practices
- Response to Diversity
- Facilitation of Learning
- Collaboration
- Systems Thinking
- Clinical Inquiry
- Learning Outcomes

At the completion of this learning activity, participants should be able to:

Validate their knowledge of progressive care nursing Briefly review the pathophysiology of single and multisystem dysfunction in adult patients and the medical and pharmacologic management of each Identify the progressive care nursing management needs for adult patients with single or multisystem organ abnormalities Successful Completion

Learners must complete 100 percent of the activity and the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.
12.8 contact hours awarded, CERP Category A
Exam Eligibility

Are you eligible to take the PCCN or PCCN-K exam=> Eligibility requirements and links to handbooks with test plans are available on their “Get Certified” pages — click here to get started: PCCN (Adult) or PCCN-K (Adult) .

PCCN and PCCN-K certifications emphasize the knowledge that the progressive nursing specialty requires and the essential acute care nursing practices that you can apply in your role every day in a step-down unit, emergency or telemetry department or another progressive care environment.

PCCN and PCCN-K specialty certifications also demonstrate your knowledge and dedication to hospital administrators, peers and patients, while giving you the satisfaction of your achievement. PCCN and PCCN-K credentials are granted by AACN Certification Corporation.

Validate and enhance your knowledge and Strengthen patient outcomes. Take advantage of this detailed review course and earn your PCCN or PCCN-K certification.

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Centers (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California Board of Registered Nursing (CBRN), Provider number CEP 1036. This activity is approved for 12.8 contact hours.

AACN programming meets the standards of most states that require mandatory CE contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

AACN and AACN Certification Corporation consider the American Nurses Association (ANA) Code of Ethics for Nurses foundational for nursing practice, providing a framework for making ethical decisions and fulfilling responsibilities to the public, colleagues and the profession. AACN Certification Corporations mission of public protection supports a standard of excellence where certified nurses have a responsibility to read about, understand and act in a manner congruent with the ANA Code of Ethics for Nurses.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (27%)
1. Acute coronary syndromes
a. non-ST segment elevation myocardial infarction
b. ST segment elevation myocardial infarction
c. unstable angina
2. Acute inflammatory disease (e.g., myocarditis, endocarditis, pericarditis)
3. Aneurysm
a. dissecting
b. repair
4. Cardiac surgery (e.g., post ICU care)
5. Cardiac tamponade
6. Cardiac/vascular catheterization
a. diagnostic
b. interventional
7. Cardiogenic shock
8. Cardiomyopathies
a. dilated (e.g., ischemic/non-ischemic)
b. hypertrophic
c. restrictive
9. Dysrhythmias
10. Heart failure
a. acute exacerbations (e.g., pulmonary edema)
b. chronic
11. Hypertension (uncontrolled)
12. Hypertensive crisis
13. Minimally-invasive cardiac surgery (i.e. nonsternal approach)
14. Valvular heart disease
15. Vascular disease
B. Pulmonary (17%)
1. Acute respiratory distress syndrome (ARDS)
2. Asthma (severe)
3. COPD exacerbation
4. Minimally-invasive thoracic surgery (e.g., VATS)
5. Obstructive sleep apnea
6. Pleural space complications (e.g., pneumothorax, hemothorax, pleural effusion, empyema, chylothorax)
7. Pulmonary embolism
8. Pulmonary hypertension
9. Respiratory depression (e.g., medicationinduced, decreased-LOC-induced)
10. Respiratory failure
a. acute
b. chronic
c. failure to wean
11. Respiratory infections (e.g., pneumonia)
12. Thoracic surgery (e.g., lobectomy, pneumonectomy)
C. Endocrine/Hematology/Neurology/Gastrointestinal/Renal (20%)
1. Endocrine
a. diabetes mellitus
b. diabetic ketoacidosis
c. hyperglycemia
d. hypoglycemia
2. Hematology/Immunology/Oncology
a. anemia
b. coagulopathies: medication-induced (e.g., Coumadin, platelet inhibitors, heparin [HIT])
3. Neurology
a. encephalopathy (e.g., hypoxic-ischemic, metabolic, infectious, hepatic)
b. seizure disorders
c. stroke
4. Gastrointestinal
a. functional GI disorders (e.g., obstruction, ileus, diabetic gastroparesis, gastroesophageal reflux, irritable bowel syndrome)
b. GI bleed
i. lower
ii. upper
c. GI infections (e.g., C. difficile)
d. GI surgeries (e.g., resections, esophagogastrectomy, bariatric)
e. hepatic disorders (e.g., cirrhosis, hepatitis, portal hypertension)
f. ischemic bowel
g. malnutrition (e.g., failure to thrive, malabsorption disorders)
h. pancreatitis
5. Renal
a. acute kidney injury (AKI)
b. chronic kidney disease (CKD)
c. electrolyte imbalances
d. end-stage renal disease (ESRD)
D. Musculoskeletal/Multisystem/Psychosocial (16%)
1. Musculoskeletal
a. functional issues (e.g., immobility, falls, gait disorders)
2. Multisystem
a. end of life
b. healthcare-acquired infections
i. catheter-associated urinary tract infections (CAUTI)
ii. central-line-associated bloodstream infections (CLABSI)
iii. surgical site infection (SSI)
c. infectious diseases
i. influenza
ii. multidrug-resistant organisms (e.g., MRSA, VRE, CRE, ESBL)
d. pain
i. acute
ii. chronic
e. palliative care
f. pressure injuries (ulcers)
g. rhabdomyolysis
h. sepsis
i. shock states
i. anaphylactic
ii. hypovolemic
j. toxic ingestion/inhalation/drug overdose
k. wounds (e.g., infectious, surgical, trauma)
3. Behavioral/Psychosocial
a. altered mental status
b. delirium
c. dementia
d. disruptive behaviors, aggression, violence
e. psychological disorders
i. anxiety
ii. depression
f. substance abuse
i. alcohol withdrawal
ii. chronic alcohol abuse
iii. chronic drug abuse
iv. drug-seeking behavior
v. drug withdrawal
II. PROFESSIONAL CARING AND ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry Cardiovascular
• Identify, interpret and monitor
o dysrhythmias
o QTc intervals
o ST segments
• Manage patients requiring
o ablation
o arterial closure devices
o arterial/venous sheaths
o cardiac catheterization
o cardioversion
o defibrillation
o pacemakers
o percutaneous coronary intervention (PCI)
o transesophageal echocardiogram (TEE)
• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
• Select leads for cardiac monitoring for the indicated disease process
• Titrate vasoactive medications
o Dobutamine
o Dopamine
o Nitroglycerin Pulmonary
• Interpret ABGs
• Maintain airway
• Monitor patients pre and post
o bronchoscopy
o chest tube insertion
o thoracentesis
• Manage patients requiring mechanical ventilation
• Manage patients requiring non-invasive O2 or ventilation delivery systems
o BiPAP
o CPAP
o face masks
o high-flow therapy
o nasal cannula
o non-breather mask
o venti-masks
• Manage patients requiring respiratory monitoring devices:
o continuous SpO2
o end-tidal CO2 (capnography)
Manage patients requiring tracheostomy tubes
• Manage patients with chest tubes (including pleural drains)
• Recognize respiratory complications and initiate interventions
Endocrine/Hematology/Neurology/Gastrointestinal/Renal
• Endocrine
o manage and titrate insulin infusions
• Hematology/Immunology/Oncology
o administer blood products and monitor patient response
• Neurology
o perform bedside screening for dysphagia
o use NIH Stroke Scale (NIHSS)
• Gastrointestinal
o manage patients pre- and post-procedure (e.g., EGD, colonoscopy)
o manage patients who have fecal containment devices
o manage patients who have tubes and drains
o recognize indications for and complications of enteral and parenteral nutrition
• Renal
o identify medications that can be removed during dialysis
o identify medications that may cause nephrotoxicity
o initiate renal protective measures for nephrotoxic procedures
o manage patients pre- and post-hemodialysis Musculoskeletal/Multisystem/Psychosocial
• Musculoskeletal
o initiate and monitor progressive mobility measures
• Multisystem
o administer medications for procedural sedation and monitor patient response
o differentiate types of wounds, pressure injuries
o manage patients with complex wounds (e.g., fistulas, drains and vacuum-assisted closure devices)
o manage patients with infections
• Psychosocial
o implement suicide prevention measures
o screen patients using a delirium test tool (e.g., CAM)
o use alcohol withdrawal test tools (e.g., CIWA)
General
• Administer medications and monitor patient response
• Anticipate therapeutic regimens
• Monitor diagnostic test results
• Perform an test pertinent to the system
• Provide health promotion interventions for patients, populations and diseases
• Provide patient and family education unique to the clinical situation
• Recognize procedural and surgical complications
• Recognize urgent situations and initiate interventions
• Use complementary alternative medicine techniques and non-pharmacologic interventions



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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