I work at both a hospital with an EMR and another one that is still paper. The paper hospital def needs a chart check. Any orders you follow are on you. If someone didn't transcribe the order correctly, you just made a med error or lab error or missed a treatment or what not. That's on you. By signing that's you've checked the chart, shows that you are accepting the chart and have corrected any errors if found. It also means you reviewed results of labs and radiology and such and are taking responsibility over calling docs, or greeting lytes or whatever. If you don't sign the chart, you are still liable for all this, but if an error does occur, it will look even worse for you.